Individual
BREANICA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19117 ESPADA DR, EDMOND, OK 73012-2611
(405) 323-4935
Mailing address
19117 ESPADA DR, EDMOND, OK 73012-2611
(405) 323-4935
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/05/2022
Last updated
01/05/2022
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