Individual
SHAWNNA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7947 17TH AVE, KENOSHA, WI 53143-5959
(262) 344-2346
Mailing address
7947 17TH AVE, KENOSHA, WI 53143-5959
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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