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General NPI Number Information
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NPI Number | 1003164849
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Entity Type | Individual
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Provider Name | BRANDI SCHMELING SMITH
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Gender | Female
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 1901 N ESTHER ST
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City | NEWBERG
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State | OR
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Zip | 97132-9529
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Country | US
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Telephone | 503-554-4319
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Fax |
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Provider Business Mailing Address
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Address Line | 3707 SUNSET LN
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City | ANTIOCH
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State | CA
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Zip | 94509-6101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2817
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License Number State | OR
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