Individual
MRS. TANESIA MICHELLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2629 W I44 SERVICE RD, SUITE 202, OKLAHOMA CITY, OK 73112
(405) 605-1865
Mailing address
2629 W I 44 SERVICE RD STE 202, OKLAHOMA CITY, OK 73112-3762
(405) 605-1865
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/29/2017
Last updated
07/21/2022
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