Individual
DEBORAH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
621 GRADE ST, KELSO, WA 98626-2606
(360) 425-5855
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60328365
WA
Other
Enumeration date
05/15/2015
Last updated
05/15/2015
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