Individual
MS. AMANDA ELLIS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
311 PIERCE AVE, MACON, GA 31204-2421
(478) 742-1775
(478) 742-1779
Mailing address
311 PIERCE AVE, MACON, GA 31204-2421
(478) 742-1775
(478) 742-1779
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002818
GA
Other
Enumeration date
01/11/2006
Last updated
07/08/2007
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