Provider Demographics
NPI:1992716773
Name:SMITH, RUTH HALLUIN (LPC)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:HALLUIN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:TILLAMOOK
Mailing Address - State:OR
Mailing Address - Zip Code:97141-2314
Mailing Address - Country:US
Mailing Address - Phone:503-842-4508
Mailing Address - Fax:503-842-4495
Practice Address - Street 1:312 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:TILLAMOOK
Practice Address - State:OR
Practice Address - Zip Code:97141-2314
Practice Address - Country:US
Practice Address - Phone:503-842-4508
Practice Address - Fax:503-842-4495
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCO502101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional