Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003143405 |
---|---|
Provider Name | Dr. Kamaria Smith |
First Address | Oklahoma City, OK 73106-6015 |
Second Address | Oklahoma City, OK 73106-6015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2009 |
Last Update Date | 12/02/2015 |