Individual
CARLA K SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, LPC-CAND.
Contact information
Practice address
5528 E RENO AVE, OKLAHOMA CITY, OK 73117-8418
(405) 512-1987
Mailing address
3004 KAEYLEE LN, DEL CITY, OK 73115-2500
(405) 512-1987
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
163W00000X
Registered Nurse
102202
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164720736
DDS
OK
Enumeration date
03/07/2011
Last updated
09/14/2021
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