Individual
CRYSTAL RENEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2109 S HIGHWAY 69, WAGONER, OK 74467-9310
(918) 640-0199
(918) 756-2126
Mailing address
2109 S HIGHWAY 69, WAGONER, OK 74467-9310
(918) 640-0199
(918) 756-2126
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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