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Individual

MRS. COLLEEN MARY SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CADCII

Contact information

Practice address
3580 MARSHALL AVE, EUGENE, OR 97402-1998
(541) 343-2996
(541) 684-4162
Mailing address
3580 MARSHALL AVE, EUGENE, OR 97402-1998
(541) 343-2993
(541) 684-4162

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
03-03-64
OR
101YM0800X
Mental Health Counselor

Other

Enumeration date
11/28/2011
Last updated
01/31/2013
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