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Individual

SHELLY M SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
15300 WATERTOWN PLANK RD STE 106, ELM GROVE, WI 53122-2348
(312) 635-4354
(888) 717-3028
Mailing address
15300 WATERTOWN PLANK RD, ELM GROVE, WI 53122-2300
(312) 635-4354
(888) 717-3028

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1102-124
WI
106H00000X
Marriage & Family Therapist
166.001023
IL
106H00000X
Marriage & Family Therapist
35001994A
IN

Other

Enumeration date
11/09/2015
Last updated
02/02/2018
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