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Individual

CHARLOTTE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.A.

Contact information

Practice address
4122 W 55TH PL, SUITES 207/208, TULSA, OK 74107-9108
(918) 791-0026
(918) 791-0043
Mailing address
PO BOX 702504, TULSA, OK 74170-2504
(918) 791-0026
(918) 791-0043

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
00000
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
OK
Enumeration date
09/01/2015
Last updated
09/01/2015
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