Individual
HEAVEN MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, SUDA
Contact information
Practice address
219 GOODING ST N, TWIN FALLS, ID 83301-6178
(208) 293-8846
Mailing address
PO BOX 684, CASTLEFORD, ID 83321-0684
(208) 569-8926
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11701
ID
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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