Individual
BECKY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 N PORTLAND ST, FOND DU LAC, WI 54935-3412
(920) 906-5100
Mailing address
50 N PORTLAND ST, FOND DU LAC, WI 54935-3412
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/09/2010
Last updated
07/09/2010
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