Individual
MRS. SHANNY J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
7010 S YALE AVE STE 215, TULSA, OK 74136-5743
(918) 492-2554
Mailing address
9210 S 71ST EAST AVE, TULSA, OK 74133-5382
(918) 524-1753
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/23/2007
Last updated
07/23/2007
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