Individual
ANNALIESE BROOKLYN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4515 E 91ST ST STE 201, TULSA, OK 74137-2862
(918) 730-9124
Mailing address
1013 S DATE AVE, BROKEN ARROW, OK 74012-5414
(918) 730-9124
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-2837192
OK
Other
Enumeration date
08/06/2026
Last updated
08/06/2026
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