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Individual

JAMES SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1608 COUNTRY RD, BLACKWELL, OK 74631-6750
(580) 363-0088
(580) 363-1963
Mailing address
1608 COUNTRY RD, BLACKWELL, OK 74631-6750

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
08/09/2013
Last updated
08/09/2013
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