Organization
SMOCKVILLE PROFESSIONAL SERVICES, INC
Active
Other names
Smockville Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GENE RANDOM HEAD (PRESIDENT)
(503) 625-2768
Entity
Organization
Contact information
Practice address
22344 SW MAIN ST, SHERWOOD, OR 97140-9416
(503) 625-2768
(503) 625-3768
Mailing address
22344 SW MAIN ST, SHERWOOD, OR 97140-9416
(503) 625-2768
(503) 625-3768
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
04/25/2008
Last updated
04/25/2008
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