person
Mr. Larry Eugene Smith SR., CADC,ICADC
Addiction (Substance Use Disorder) Counselor in Grove, Oklahoma
NPI 1548469448

Larry Eugene Smith SR. is an Addiction (Substance Use Disorder) Counselor based in Grove, OK and is specialized in Addiction (Substance Use Disorder). Larry Eugene Smith SR. practices in Grove, OK and has the professional credentials of CADC,ICADC. The NPI Number for Larry Eugene Smith SR. is 1548469448 and holds a License No. 46, 13162 (Oklahoma).

The current practice location address for Larry Eugene Smith SR. is 32208 S. 620 Rd, Grove, OK and can be reached out via phone at 918-787-7769 and via fax at 918-787-7761.

Location: 32208 S. 620 Rd, Grove, OK, 74345-1585
person
Provider Profile Details
NPI Number
1548469448
Provider Name
Larry Eugene Smith SR.
Credential
CADC,ICADC
Provider Entity Type
Individual
Gender
Male
Address
32208 S. 620 Rd, Grove, OK, 74345-1585
Phone Number
918-787-7769
Fax Number
918-787-7761
Provider Enumeration Date
07/12/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
46,13162 01 OK CADC, ICADC
institution
Provider Business Practice Location Address Details
Address
32208 S. 620 Rd
City
State
Zip
74344
Phone Number
918-787-7769
Fax Number
918-787-7761
person
Provider Business Mailing Address Details
Address
32208 S. 620 Rd
City
State
Zip
74344
Phone Number
918-787-7769
Fax Number
918-787-7761
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
46, 13162 (Oklahoma)
Definition
Definition to come...
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