Individual
JAQUICA LOURDES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 N PATRICK BLVD STE 250, BROOKFIELD, WI 53045-5883
(888) 754-0398
Mailing address
9418 N GREEN BAY RD APT 130, BROWN DEER, WI 53209-1067
(414) 439-8009
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB743497
WI
Other
Enumeration date
07/19/2022
Last updated
07/19/2022
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