Provider Demographics
NPI:1871232314
Name:SMITH, TIERANI
Entity Type:Individual
Prefix:
First Name:TIERANI
Middle Name:
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 1:14001 MCAULEY BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-7006
Mailing Address - Country:US
Mailing Address - Phone:405-464-9595
Mailing Address - Fax:405-493-6787
Practice Address - Street 1:14001 MCAULEY BLVD STE 150
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-7006
Practice Address - Country:US
Practice Address - Phone:405-464-9595
Practice Address - Fax:405-493-6787
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5547235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist