Provider Demographics
NPI:1841515673
Name:SMITH, KARINA NICOLE
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:NICOLE
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 1:2025 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5168
Mailing Address - Country:US
Mailing Address - Phone:405-473-6718
Mailing Address - Fax:
Practice Address - Street 1:2525 NW EXPRESSWAY
Practice Address - Street 2:SUITE 624A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7227
Practice Address - Country:US
Practice Address - Phone:405-473-6718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor