Individual
BAILEY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2233 NW 198TH ST, EDMOND, OK 73012-5203
(630) 605-3243
Mailing address
2233 NW 198TH ST, EDMOND, OK 73012-5203
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S53006188785
—
IL
Enumeration date
01/27/2011
Last updated
01/27/2011
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