Individual
TAMAKA TYSIONIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 BLAKE AVE, SOUTH MILWAUKEE, WI 53172-3923
(574) 703-4531
Mailing address
3521 N 54TH BLVD, MILWAUKEE, WI 53216-2803
(574) 703-4531
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/15/2018
Last updated
05/23/2025
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