Individual
MS. TRICIA LEANNIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS PSYCHOLOGIST ASSO
Contact information
Practice address
837 ALDER CREEK DR, MEDFORD, OR 97504-8911
(541) 608-3878
(541) 608-3880
Mailing address
837 ALDER CREEK DR, MEDFORD, OR 97504-8911
(541) 608-3878
(541) 608-3880
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5057
OR
103TC0700X
Clinical Psychologist
5057
OR
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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