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Individual

LISA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC-IT

Contact information

Practice address
115 5TH AVE S, LA CROSSE, WI 54601-9200
(608) 797-5679
Mailing address
1732 BAINBRIDGE ST, LA CROSSE, WI 54603-1413
(608) 369-0758

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7372-226
WI
101YM0800X
Mental Health Counselor
Primary
WI

Other

Enumeration date
06/23/2023
Last updated
06/23/2023
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