Smith, Olivia L

Smith, Olivia L is an individual health care provider with primary practice located at 12075 Corporate Pkwy Ste 110 , Mequon WI 53092-2664. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Smith, Olivia L can be contacted via phone (877) 486-4140.

Contact Information

Primary practice address
12075 Corporate Pkwy Ste 110 Mequon WI 53092-2664
Fax: (847) 486-4145
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-15-19887 Illinois

Profile Details

NPI number 1942666045
LBN Legal business name Smith, Olivia L
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2016
Last updated Jan 9th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942666045 NPPES
Wisconsin Other 129-140 STATE OF WISCONSIN

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