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1114779451
ROGER P SMITH
GREEN BAY, WI
NPI
1114779451
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 20519)
Enumeration Date
2024-04-02
Last Update Date
2024-04-02
Business Address
ROGER P SMITH
2357 W MASON ST
GREEN BAY, WI 54303-4708
Phone number: 920-337-6740
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Mailing Address
ROGER P SMITH
2357 W MASON ST
GREEN BAY, WI 54303-4708
Phone number: 920-337-6740
Copy
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