Doctor Name: | MARCIE J SMITH |
NPI Number: | 1053540559 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC, NCC |
License Number: | |
Business Practice Address: | 226 State St St Charles, IL - 601741864 |
Business Phone Number: | 6305873777 |
Business Fax Number: | 6305873791 |
Mailing Address: | 226 State St, ST CHARLES |
State: | IL |
Postal Code: | 601741864 |
Phone Number: | 6305873777 |
Fax Number: | 6305873791 |
NPI Enumeration Date: | 07/07/2009 |
NPI Last Update Date: | 08/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | School |
Taxonomy Definition: |