Individual
CLARENCE RUSSELL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1311 N LOTTIE AVE, OKLAHOMA CITY, OK 73117-2051
(405) 600-3074
(405) 605-8120
Mailing address
1311 N LOTTIE AVE, OKLAHOMA CITY, OK 73117-2051
(405) 600-3074
(405) 605-8120
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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