Individual
CORNELIUS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6001 W CENTER ST, MILWAUKEE, WI 53210-2154
(920) 815-6627
Mailing address
8543 W FAIRY CHASM DR, MILWAUKEE, WI 53224-1809
(414) 391-4479
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
07/16/2019
Last updated
02/17/2021
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