Individual
DAVID SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
10900 67TH STREET, KENOSHA, WI 53142
(262) 914-7422
Mailing address
5439 DURAND AVE, SUITE 240B, MOUNT PLEASANT, WI 53406-5058
(262) 914-7422
(262) 671-0016
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6231-125
WI
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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