Individual
AMY JOY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(800) 678-5500
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362009093
MI
Other
Enumeration date
05/29/2020
Last updated
09/02/2020
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