Individual
AMY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22968 VIA NUEZ, MISSION VIEJO, CA 92691-5326
(714) 931-5908
Mailing address
22968 VIA NUEZ, MISSION VIEJO, CA 92691-5326
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-36068
CA
Other
Enumeration date
07/09/2019
Last updated
08/31/2023
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