Individual
AMANDA GRAY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
190 BRIDGE ST APT 1212, SALEM, MA 01970-7412
(781) 502-8972
Mailing address
190 BRIDGE ST APT 1212, SALEM, MA 01970-7412
(781) 502-8972
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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