Individual
DERRICK EDWARD SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COUNSELOR/THERAPIST
Contact information
Practice address
222 HOLIDAY DR, WHITE RIVER JUNCTION, VT 05001-2043
(802) 295-2943
Mailing address
11337 SW IRONWOOD LOOP, TIGARD, OR 97223-4200
(503) 521-6146
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/16/2010
Last updated
11/16/2010
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