Doctor Name: | GINGER REAH SMITH |
NPI Number: | 1619264496 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | |
Business Practice Address: | 620 Flynn St Alva, OK - 737172242 |
Business Phone Number: | 5803272900 |
Business Fax Number: | 5803271337 |
Mailing Address: | 620 Flynn St, ALVA |
State: | OK |
Postal Code: | 737172242 |
Phone Number: | 5803272900 |
Fax Number: | 5803271337 |
NPI Enumeration Date: | 06/30/2011 |
NPI Last Update Date: | 06/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |