Individual
BRANDON G. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC/MH
Contact information
Practice address
230 E 12TH ST, ADA, OK 74820-6508
(580) 332-3001
(580) 332-8774
Mailing address
230 E 12TH ST, ADA, OK 74820-6508
(405) 332-3001
(580) 332-8774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1450
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/29/2016
Last updated
07/29/2024
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