Individual
CARROL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
8937 S GARNETT RD, BROKEN ARROW, OK 74012-6018
(918) 872-9777
Mailing address
2990 N SIOUX AVE, CLAREMORE, OK 74017-3700
(918) 342-2622
(918) 342-2641
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12101988
DOB
—
Enumeration date
07/05/2018
Last updated
07/05/2018
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