Individual
DR. DEREK JAMES SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2853 E BENT TREE LN, HARRISON, ID 83833-8674
(208) 755-7393
Mailing address
2853 E BENT TREE LN, HARRISON, ID 83833-8674
(208) 755-7393
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
11022713-2501
UT
103T00000X
Psychologist
Primary
PSY-203364
ID
Other
Enumeration date
06/23/2016
Last updated
05/04/2021
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