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Individual

TARA A SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ED.S, LPC, NCSP

Contact information

Practice address
501 SE 4TH ST STE C, MOORE, OK 73160-6831
(405) 653-8012
(877) 715-9937
Mailing address
624 SW 159TH TER, OKLAHOMA CITY, OK 73170-7626
(405) 653-7269

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC07270
OK
101YP2500X
Professional Counselor
103T00000X
Psychologist
12-49 AE-PL
AR
222Q00000X
Developmental Therapist

Other

Enumeration date
04/15/2013
Last updated
03/04/2025
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