Individual
DR. KELLY JEAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., LPC
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6771
Mailing address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6771
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7421-125
WI
Other
Enumeration date
05/08/2020
Last updated
05/08/2020
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