Jaqualyn A Smith

NPI #1902408727 in Broken Arrow, Oklahoma

Provider Information

NPI Number: 1902408727
Entity Type: Individual
Name: Jaqualyn A Smith
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Nov 16, 2020
Last Updated: Nov 16, 2020

Practice Location

Address: 308 N ASPEN AVE
City: Broken Arrow
State: Oklahoma
ZIP Code: 74012-2205
Phone: (539) 777-0940

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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