Individual
JAMES EDMOND SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 N BROADWAY ST STE 100, MOORE, OK 73160-5135
(405) 990-0816
Mailing address
12718 N MACARTHUR BLVD APT K, OKLAHOMA CITY, OK 73142-2909
(405) 388-9464
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
09/05/2018
Last updated
09/05/2018
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