Smockville Professional Services, INC

NPI #1457526964 in Sherwood, Oregon

Provider Information

NPI Number: 1457526964
Entity Type: Organization
Organization Name: Smockville Professional Services, INC
Primary Specialty: Psychologist - Cognitive & Behavioral
Enumeration Date: Apr 25, 2008
Last Updated: Apr 25, 2008

Practice Location

Address: 22344 SW MAIN ST
City: Sherwood
State: Oregon
ZIP Code: 97140-9416
Phone: (503) 625-2768

Authorized Official

Name: MR. GENE RANDOM HEAD
Title: PRESIDENT
Phone: (503) 625-2768

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Cognitive & Behavioral — Cognitive & Behavioral	103TB0200X	Primary

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