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Individual

DANIELLE J SMALLWOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSS

Contact information

Practice address
945 SE UGLOW AVE, DALLAS, OR 97338-2642
(503) 837-1762
Mailing address
1630 MONMOUTH ST APT 13, INDEPENDENCE, OR 97351-1010
(971) 701-0522

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000110313
OR

Other

Enumeration date
02/06/2024
Last updated
02/06/2024
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