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NPI Code Detail

MEDICARE: KIMBERLY CAROL MCCLEARYSMITH CASEMANAGER, BHRS

MEDICARE: KIMBERLY CAROL MCCLEARYSMITH CASEMANAGER, BHRS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1225351521
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY CAROL MCCLEARYSMITH CASEMANAGER, BHRS
Provider Business Mailing Address
First Line : 8507 NE 47TH ST
Second Line :
City : SPENCER
State : OK
Zip : 73084-2007
Country : US
Telephone Number : 405-833-6876
Fax Number :
Provider Business Practice Location Address
First Line : 316 S MIDWEST BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73110-4642
Country : US
Telephone Number : 405-733-5437
Fax Number : 405-732-7441
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2010
Last Update Date : 03/01/2010

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Directions to “ KIMBERLY CAROL MCCLEARYSMITH CASEMANAGER, BHRS” Practice Location

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