Individual
MR. DAVIENE SMITTIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4001 W CAPITOL DR, MILWAUKEE, WI 53216-2530
(414) 326-7160
Mailing address
4001 W CAPITOL DR, MILWAUKEE, WI 53216-2530
(414) 326-7160
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2147-226
WI
Other
Enumeration date
05/28/2014
Last updated
06/17/2016
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