Individual
KELLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
545 SW 26TH ST, OKLAHOMA CITY, OK 73109-6740
(405) 425-2999
Mailing address
545 SW 26TH ST, OKLAHOMA CITY, OK 73109-6740
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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