Provider Demographics
NPI:1316691678
Name:SMITH, PAULA (MSW)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 N LINCOLN BLVD UNIT 2016
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-3422
Mailing Address - Country:US
Mailing Address - Phone:405-306-8719
Mailing Address - Fax:
Practice Address - Street 1:4545 N LINCOLN BLVD UNIT 2016
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-3422
Practice Address - Country:US
Practice Address - Phone:405-306-8719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer