Most Relevant Information
Provider Data
| NPI Number: | 1003005455 |
| Provider Name: | NANCI ROSE SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/22/2007 |
| Last Updated: | 10/22/2007 |
Provider Practice Location
175 W B ST
BUILDING I
SPRINGFIELD
OR
974774575
Practice Location Phone/Fax
| Phone: | 5419881025 |
| Fax: |
Provider Mailing Location
175 W B ST
BUILDING I
SPRINGFIELD
OR
974774575
Provider Mailing Phone/Fax
| Phone: | 5419881025 |
| Fax: |