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Individual

ANDREA MARIE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LLBSW

Contact information

Practice address
507 36TH ST SE, WYOMING, MI 49548-2339
(616) 247-4508
Mailing address
585 JEWETT RD, MASON, MI 48854-8729
(517) 676-5405

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
6802088746
MI
171M00000X
Case Manager/Care Coordinator
Primary
6802088746
MI

Other

Enumeration date
12/01/2015
Last updated
12/01/2015
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