Provider Demographics
NPI:1669759593
Name:SMITH, SHARRON PATRECE (BA)
Entity type:Individual
Prefix:MRS
First Name:SHARRON
Middle Name:PATRECE
Last Name:SMITH
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16224 OKALEE LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1289
Mailing Address - Country:US
Mailing Address - Phone:405-285-2041
Mailing Address - Fax:
Practice Address - Street 1:16224 OKALEE LN
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1289
Practice Address - Country:US
Practice Address - Phone:405-285-2041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-06
Last Update Date:2011-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health