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Individual

TYLER THOMPSON SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
199 COUNTY DF, JUNEAU, WI 53039-9512
(920) 386-3500
Mailing address
504 MIDGE ST, JOHNSON CREEK, WI 53038

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12097-123
WI
1041C0700X
Clinical Social Worker

Other

Enumeration date
04/13/2023
Last updated
02/26/2025
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