Individual
DEREK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC-R
Contact information
Practice address
1651 CENTENNIAL BLVD, SPRINGFIELD, OR 97477-3363
(541) 762-4533
Mailing address
1651 CENTENNIAL BLVD, SPRINGFIELD, OR 97477-3363
(541) 762-4533
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-22-1372
OR
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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