Doctor Name: | MS. ANDREA DENISE SMITH |
NPI Number: | 1023128576 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CM-A |
License Number: | |
Business Practice Address: | 200 N Choctaw Ave # 120 El Reno, OK - 730362624 |
Business Phone Number: | 4052626662 |
Business Fax Number: | 4052626860 |
Mailing Address: | 200 N Choctaw Ave, # 120 EL RENO |
State: | OK |
Postal Code: | 730362624 |
Phone Number: | 4052626662 |
Fax Number: | 4052626860 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |