Individual
MRS. AMANDA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2225 US HIGHWAY 41 N, TIFTON, GA 31794-2749
(229) 391-4100
Mailing address
907 18TH ST E STE 400, TIFTON, GA 31794-3684
(229) 353-3422
(229) 353-6060
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004961
GA
1041C0700X
Clinical Social Worker
SW10994
FL
Other
Enumeration date
10/15/2012
Last updated
04/01/2021
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