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Individual

DR. DAVID BRIAN SMOTHERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D., L.P.

Contact information

Practice address
10425 W NORTH AVE, WAUWATOSA, WI 53226-2416
(414) 367-9413
(414) 358-5590
Mailing address
9120 W HAMPTON AVE STE 212, WSPP, MILWAUKEE, WI 53225-4960
(414) 464-9777

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3865-125
WI
103TC0700X
Clinical Psychologist
Primary
2973-57
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MA 43599400
WI
Enumeration date
02/21/2007
Last updated
03/17/2018
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