Individual
MRS. LISA IRENE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26685 DUCK POND LN, CLAREMORE, OK 74019-7536
(918) 557-7575
Mailing address
26685 DUCK POND LN, CLAREMORE, OK 74019-7536
(918) 557-7575
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3411
OK
Other
Enumeration date
04/30/2010
Last updated
04/30/2010
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