Marissa Star Smith

NPI #1992550917 in Mchenry, Illinois

Provider Information

NPI Number: 1992550917
Entity Type: Individual
Name: Marissa Star Smith
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Enumeration Date: Apr 22, 2024
Last Updated: Apr 22, 2024

Practice Location

Address: 113 VERNON DR
City: Mchenry
State: Illinois
ZIP Code: 60051-8652
Phone: (847) 450-9635

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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