| Doctor Name: | MS. JUANITA LOUISE SMITH |
| NPI Number: | 1124364963 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 2299795 |
| Business Practice Address: | 939 Honey Ln Crete, IL - 604171329 |
| Business Phone Number: | 7086744837 |
| Business Fax Number: | 7086729883 |
| Mailing Address: | 939 Honey Ln, CRETE |
| State: | IL |
| Postal Code: | 604171329 |
| Phone Number: | 7086744837 |
| Fax Number: | 7086729883 |
| NPI Enumeration Date: | 12/26/2012 |
| NPI Last Update Date: | 12/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YS0200X |
| License Number: | 2299795 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |