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Individual

KRISTIN D SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
9200 W WISCONSIN AVE, NEUROPSYCHOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-5660
(414) 259-9012
Mailing address
9200 W WISCONSIN AVE, NEUROPSYCHOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-5660
(414) 259-9012

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2873
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1376864710
WI
Enumeration date
06/21/2010
Last updated
11/01/2011
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