Individual
AMANDA LASHAE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
70 E SECOND ST, CROSSVILLE, TN 38555-4564
(931) 267-9063
Mailing address
4521 STANDING ROCK RD, DEER LODGE, TN 37726-5013
(931) 267-9063
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11881
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11881
LICENSED MASSAGE THERAPIST
TN
Enumeration date
12/05/2018
Last updated
12/05/2018
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