Individual
MRS. JESSICA J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHR
Contact information
Practice address
2500 MCGEE DR STE 104, NORMAN, OK 73072-6705
(405) 623-3081
Mailing address
PO BOX 720562, NORMAN, OK 73070-4414
(405) 623-3081
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12289582
—
OK
Enumeration date
03/05/2019
Last updated
03/05/2019
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