Individual
MS. CAROL ALICE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6480
Mailing address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6480
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16026-131
WI
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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