Smothers, David Brian
Smothers, David Brian is an individual health care provider with primary practice located at 10425 W North Ave , Wauwatosa WI 53226-2416. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Smothers, David Brian can be contacted via phone (414) 367-9413.Contact Information
Primary practice address
10425 W North Ave
Wauwatosa WI 53226-2416
Phone: (414) 367-9413
Fax: (414) 358-5590
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 3865-125 | Wisconsin |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2973-57 | Wisconsin |
Profile Details
| NPI number | 1902931132 |
|---|---|
| LBN Legal business name | Smothers, David Brian |
| Credentials | PSY.D., L.P. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2007 |
| Last updated | Mar 17th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902931132 | NPPES |
| Wisconsin | MEDICAID | MA 43599400 |
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