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General NPI Number Information
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NPI Number | 1114797495
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Entity Type | Individual
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Provider Name | ANN MARIE SMITH
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Gender | Female
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 1724 NW 4TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73106-2609
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Country | US
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Telephone | 405-295-5167
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Fax |
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Provider Business Mailing Address
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Address Line | 11308 SW 5TH ST APT 5537
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City | YUKON
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State | OK
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Zip | 73099-0231
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Country | US
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Telephone | 405-999-7408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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