Individual
AMY AMANDA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 VETERANS AVE, BILOXI, MS 39531-2410
(228) 523-4372
Mailing address
1525 E PASS RD, APT. 316, GULFPORT, MS 39507-3548
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C6897
MS
Other
Enumeration date
12/19/2007
Last updated
12/09/2014
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