Individual
COLETTE ELLEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CADC
Contact information
Practice address
12 GILBERT RD, MURPHYSBORO, IL 62966-4624
(618) 521-0015
Mailing address
12 GILBERT RD, MURPHYSBORO, IL 62966-4624
(618) 521-0015
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.013261
IL
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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