Doctor Name: | PATRICIA SMITH |
NPI Number: | 1043374341 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., L.C.P.C. |
License Number: | |
Business Practice Address: | 10735 S Cicero Ave Suite 208 Oak Lawn, IL - 604535400 |
Business Phone Number: | 7084240001 |
Business Fax Number: | 7084241394 |
Mailing Address: | 8950 Lunar Ave, ORLAND PARK |
State: | IL |
Postal Code: | 604623304 |
Phone Number: | 7083457512 |
Fax Number: | |
NPI Enumeration Date: | 12/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |