Individual
TRACEY LEONE SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
6001 RESEARCH PARK BLVD, MADISON, WI 53719
(608) 263-6100
(608) 833-6932
Mailing address
8007 EXCELSIOR DRIVE, MADISON, WI 53717
(608) 829-5238
(608) 833-6932
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2548
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39142900
—
WI
Enumeration date
02/27/2006
Last updated
07/08/2007
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