Provider Demographics
NPI:1689075046
Name:SMITH, LAUREN MARIE
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3158 NW EXPRESSWAY
Mailing Address - Street 2:APT 431
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4160
Mailing Address - Country:US
Mailing Address - Phone:405-412-9703
Mailing Address - Fax:
Practice Address - Street 1:3158 NW EXPRESSWAY
Practice Address - Street 2:APT 431
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4160
Practice Address - Country:US
Practice Address - Phone:405-412-9703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)