Smith, Jaqualyn A

Smith, Jaqualyn A is an individual health care provider with primary practice located at 308 N Aspen Ave , Broken Arrow OK 74012-2205. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Smith, Jaqualyn A can be contacted via phone (539) 777-0940.

Contact Information

Primary practice address
308 N Aspen Ave Broken Arrow OK 74012-2205
Phone: (539) 777-0940
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1902408727
LBN Legal business name Smith, Jaqualyn A
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2020
Last updated Nov 16th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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