Individual
DR. MICHAEL DAVID SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3168
WI
103TC0700X
Clinical Psychologist
PS015414
PA
Other
Enumeration date
10/02/2012
Last updated
07/09/2019
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