Individual
AMANDA SMOTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1018 N BRAGG BLVD, SPRING LAKE, NC 28390-3316
(910) 295-2609
Mailing address
3728 COACH LANTERN AVE, WAKE FOREST, NC 27587-3403
(757) 513-1909
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-50565
NC
106E00000X
Assistant Behavior Analyst
0-19-9873
VA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/29/2018
Last updated
01/09/2024
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