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NPI Code Detail

MEDICARE: TERESA SMITH

MEDICARE: TERESA SMITH
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1720748346
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA SMITH
Provider Business Mailing Address
First Line : 14828 SERENITA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73134-2028
Country : US
Telephone Number : 405-839-7500
Fax Number :
Provider Business Practice Location Address
First Line : 14828 SERENITA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73134-2028
Country : US
Telephone Number : 405-839-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2021
Last Update Date : 12/22/2021

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Directions to “ TERESA SMITH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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