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Provider Information for 1891847786


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RILDA J SMITH LMFT


Sex: Female

NPI: 1891847786
Last Updated: 2007-07-08
Certification Date:

Details

NameValue
NPI1891847786
Enumeration Date2007-01-18
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1517 N BEARD ST
SHAWNEE, OK 74804-4401
United States

Phone: 405-659-7973 | Fax:
 
Primary Practice Address 2413 N KICKAPOO AVE
SHAWNEE, OK 74804-2501
United States

Phone: 405-659-7973 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 106H00000X - Marriage & Family Therapist OK853