Individual
BIANCA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
308 N ASPEN AVE, BROKEN ARROW, OK 74012-2205
(539) 777-0940
Mailing address
1551 N OKMULGEE AVE APT 310, OKMULGEE, OK 74447-2286
(495) 465-3449
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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