Alexander Blake Smith

NPI #1700566189 in Peoria, Illinois

Provider Information

NPI Number: 1700566189
Entity Type: Individual
Name: Alexander Blake Smith
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jul 20, 2023
Last Updated: Jul 20, 2023

Practice Location

Address: 507 E ARMSTRONG AVE
City: Peoria
State: Illinois
ZIP Code: 61603-3201
Phone: (300) 968-6117

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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