Individual
TOMMIE J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
1219 K ST NW STE 2, ARDMORE, OK 73401-1801
(580) 798-4523
Mailing address
PO BOX 189, ARDMORE, OK 73402-0189
(580) 310-7305
(580) 319-7328
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
#4003
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100685660A
—
OK
05
—
100685660D
—
OK
Enumeration date
11/09/2006
Last updated
11/24/2024
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