Individual
AMANDA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2825 HILLEGAS RD, FORT WAYNE, IN 46808-3859
(260) 338-1241
Mailing address
4935 HILLEGAS RD STE 200, FORT WAYNE, IN 46818-1943
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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