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General NPI Number Information
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NPI Number | 1396218152
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Entity Type | Organization
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Legal Business Name | SUMMER SMITH THERAPY
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Dates
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Enumeration Date | 01/04/2019
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Last Update Date | 01/04/2019
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Provider Practice Location Address
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Address Line | 11209 N MAY AVE STE B
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120
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Country | US
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Telephone | 405-517-4270
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Fax |
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Provider Business Mailing Address
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Address Line | 2617 ACACIA CT
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City | NORMAN
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State | OK
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Zip | 73072-6838
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Country | US
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Telephone | 405-517-4270
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUMMER WELCHER SMITH
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Credential | LCSW
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Telephone | 405-517-4270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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