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Individual

SALLY SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
492 E 13TH AVE, SUITE 205, EUGENE, OR 97401-4268
(541) 968-6321
Mailing address
492 E 13TH AVE, SUITE 205, EUGENE, OR 97401-4268
(541) 968-6321

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
96-04-64
OR
1041C0700X
Clinical Social Worker

Other

Enumeration date
10/28/2008
Last updated
02/19/2013
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