Individual
ANDREA SUZANNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3936 CIRCLE DR, HOLMEN, WI 54636-9187
(608) 413-4825
Mailing address
407 16TH AVE S, BANGOR, WI 54614-8794
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/19/2025
Last updated
02/20/2025
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