Individual
MRS. JESSICA NICOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2761 S 114TH EAST AVE, TULSA, OK 74129-8049
(918) 740-5023
Mailing address
2761 S 114TH EAST AVE, TULSA, OK 74129-8049
(918) 740-5023
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/02/2017
Last updated
08/26/2020
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