Individual
DR. LAURIE S SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7617 MINERAL POINT RD, STE 300, MADISON, WI 53717-1623
(608) 833-9290
(608) 833-9691
Mailing address
7617 MINERAL POINT RD, STE 300, MADISON, WI 53717-1623
(608) 833-9290
(608) 833-9691
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
1632-057
WI
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1632-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002584027
MEDICARE ID
WI
01
—
13344
DEAN CARE
WI
05
—
39199900
—
WI
Enumeration date
06/14/2006
Last updated
01/19/2011
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