Individual
DIANNE MARIE SMITH-O'CONNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
279 S 17TH AVE, WEST BEND, WI 53095-3001
(262) 542-3255
(262) 306-9317
Mailing address
188 PO ST, WEST BEND, WI 53090-2520
(262) 334-7227
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1705-123
WI
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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