Individual
MRS. AMY PHELAN SMITH TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 44118-4819
(216) 320-8293
Mailing address
1113 S BELVOIR BLVD, SOUTH EUCLID, OH 44121-2946
(612) 578-2435
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
I.0900275
OH
1041C0700X
Clinical Social Worker
Primary
I.0900275-SUPV
OH
Other
Enumeration date
07/06/2010
Last updated
12/15/2010
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