Individual
JESSICA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1806 24TH AVE NW, NORMAN, OK 73069-6392
(405) 802-0977
Mailing address
1806 24TH AVE NW, NORMAN, OK 73069-6392
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-161442
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N083851300
DRIVERS LICENSE NUMBER
OK
Enumeration date
07/16/2021
Last updated
09/25/2025
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