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1710502505
SALLY SMITH
MOORE, OK
NPI
1710502505
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 207)
Enumeration Date
2020-06-08
Last Update Date
2020-06-08
Business Address
SALLY SMITH LADC
4525 SOUTHCREEK RD
MOORE, OK 73165-7359
Phone number: 405-226-7473
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Mailing Address
SALLY SMITH LADC
4525 SOUTHCREEK RD
MOORE, OK 73165-7359
Phone number: 405-226-7473
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