Individual
ELIZABETH MAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2065 NE TUCSON WAY APT 110, BEND, OR 97701-5182
(541) 383-3005
(541) 383-1883
Mailing address
PO BOX 4228, PORTLAND, OR 97208-4228
(541) 316-6026
(541) 323-3866
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L10772
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500700865
—
OR
Enumeration date
08/04/2014
Last updated
10/14/2024
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