Individual
CHARLES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
905 HOLIDAY DR, ARDMORE, OK 73401-1216
(580) 226-5003
Mailing address
905 HOLIDAY DR, ARDMORE, OK 73401-1216
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/29/2023
Last updated
08/27/2024
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