Individual
MRS. THERESA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
620 SCHOENHAAR DR, WEST BEND, WI 53090-2649
(262) 306-8450
(262) 306-8451
Mailing address
745 MAIN ST APT 7, KEWASKUM, WI 53040-9275
(262) 337-3328
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3302-154
WI
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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