Provider Information for 1245006584
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ELIZABETH ANN SMITH LCSW
Sex: Female
NPI: 1245006584
Last Updated: 2023-11-28
Certification Date: 2023-11-28
Certification Date: 2023-11-28
Details
Name | Value | ||||||||
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NPI | 1245006584 | ||||||||
Enumeration Date | 2023-11-28 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 2299 SWAN DR FREEPORT, IL 61032-8352 United States Phone: 815-275-4581 | Fax: | ||||||||
Primary Practice Address | 2299 SWAN DR FREEPORT, IL 61032-8352 United States Phone: 815-275-4581 | Fax: | ||||||||
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