Individual
BURL AMBER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSS
Contact information
Practice address
20370 POE SHOLES DR, BEND, OR 97703-7938
(541) 318-1377
Mailing address
1943 NE HIGHER GROUND AVE, BEND, OR 97701-6487
(831) 920-7201
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000109693
OR
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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