Individual
MRS. AMANDA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 773-0530
Mailing address
8450 SOPHIE LN, GREENWOOD, LA 71033-3402
(318) 773-0530
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12908
LA
Other
Enumeration date
02/28/2017
Last updated
12/16/2022
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