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1972136620
DOUG C SMITH
CHAMPAIGN, IL
NPI
1972136620
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149014719)
Enumeration Date
2020-02-20
Last Update Date
2020-02-20
Business Address
DOUG C SMITH
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820-2101
Phone number: 217-356-1558
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Mailing Address
DOUG C SMITH
206 CATTAIL
SAVOY, IL 61874-9498
Phone number: 217-419-6260
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