Individual
MRS. JESSICA ANN SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1220 DEWEY AVE, WAUWATOSA, WI 53213-2504
(414) 454-6795
(414) 454-6736
Mailing address
7715 LIVINGSTON AVE, WAUWATOSA, WI 53213-1123
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1346140
WI
1835P1300X
Psychiatric Pharmacist
1346140
WI
Other
Enumeration date
03/20/2013
Last updated
03/20/2013
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