Individual
EDWARD G. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2601 N MARTIN LUTHER KING DR, MILWAUKEE, WI 53212-2711
(414) 263-8352
(414) 264-2264
Mailing address
6400 INDUSTRIAL LOOP, GREENDALE, WI 53129-2452
(414) 423-4100
(414) 423-4134
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
320-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39588700
—
WI
Enumeration date
01/16/2008
Last updated
01/28/2014
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