Individual
DIANDRIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
4127 NW 122ND ST STE C, OKLAHOMA CITY, OK 73120-8880
(405) 455-6868
(405) 562-3444
Mailing address
17613 CRANBROOK RD, EDMOND, OK 73012-6954
(405) 519-3170
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-21-52366
OK
Other
Enumeration date
03/04/2014
Last updated
05/23/2024
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