Individual
AMANDA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
496 SMITHTOWN BYP, SUITE 304, SMITHTOWN, NY 11787-5005
(631) 877-6777
Mailing address
680 N INDIANA AVE, LINDENHURST, NY 11757-2910
(631) 877-6777
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6366
NY
Other
Enumeration date
12/19/2014
Last updated
01/16/2017
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