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1083077010
SIEDAH NICOLE SMITH
CHAMPAIGN, IL
NPI
1083077010
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2016-03-29
Last Update Date
2016-03-29
Business Address
SIEDAH NICOLE SMITH
1801 FOX DR
CHAMPAIGN, IL 61820-7236
Phone number: 217-398-8080
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Mailing Address
SIEDAH NICOLE SMITH
1401 QUEENS WAY
CHAMPAIGN, IL 61821-1034
Phone number: 217-552-8211
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