Individual
LOIS EILEEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
COYOTE RIDGE CORRECTION CENTER, 1301 NORTH EPHRATA AVE., CONNELL, WA 99326
(509) 543-5921
Mailing address
13242 ROAD 24 SW, MATTAWA, WA 99349-7205
(509) 380-0042
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60080431
WA
Other
Enumeration date
10/19/2018
Last updated
10/19/2018
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