Individual
IAN KENNETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3113 E WASHINGTON AVE, MADISON, WI 53704-4330
(608) 416-5777
Mailing address
3113 E WASHINGTON AVE, MADISON, WI 53704-4330
(608) 416-5777
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/28/2022
Last updated
12/28/2022
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