Individual
JESSICA LYNN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2530 S COMMERCE ST, ARDMORE, OK 73401-5519
(580) 223-2537
Mailing address
2530 S COMMERCE ST, ARDMORE, OK 73401-5519
(580) 223-2537
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728830M
—
OK
Enumeration date
01/13/2014
Last updated
01/13/2014
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