Individual
JEANETTE M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, MDIV
Contact information
Practice address
433 W WILSHIRE BLVD, SUITE B, OKLAHOMA CITY, OK 73116-7777
(405) 242-5082
Mailing address
433 W WILSHIRE BLVD, SUITE B, OKLAHOMA CITY, OK 73116-7777
(405) 242-5082
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3606
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
3606
OK
101YM0800X
Mental Health Counselor
3606
OK
101YP1600X
Pastoral Counselor
3606
OK
101YP2500X
Professional Counselor
3606
OK
106H00000X
Marriage & Family Therapist
3606
OK
Other
Enumeration date
11/28/2008
Last updated
11/28/2008
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