Provider Information for 1629465240
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Mrs. KERI ANN SMITH LPC
Other Names:Former Name:KERI ALVASex: Female
NPI: 1629465240
Last Updated: 2022-08-18
Certification Date: 2022-08-18
Certification Date: 2022-08-18
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1629465240 | ||||||||
| Enumeration Date | 2015-04-21 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 109 N FAIRLAND ST PRYOR, OK 74361-4205 United States Phone: 918-825-1405 | Fax:918-825-1406 | ||||||||
| Primary Practice Address | 109 N FAIRLAND ST PRYOR, OK 74361-4205 United States Phone: 918-825-1405 | Fax:918-825-1406 | ||||||||
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