Individual
DR. AMANDA BRANDNER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
I3-0001341
DE
152WV0400X
Vision Therapy Optometrist
13-0001341
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12078052
CAQH
—
01
—
13-0001341
PROFESSIONAL LICENSE
DE
Enumeration date
12/08/2009
Last updated
01/27/2021
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