Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003175704 |
---|---|
Provider Name | Todd J Smetana |
First Address | Tulsa, OK 74112-7116 |
Second Address | Tulsa, OK 74146-6831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2012 |
Last Update Date | 19/02/2019 |