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General NPI Number Information
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NPI Number | 1063771020
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Entity Type | Organization
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Legal Business Name | AMANDA K. SMITH, MA, LMHC, PA
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Dates
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Enumeration Date | 05/11/2012
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Last Update Date | 05/11/2012
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Provider Practice Location Address
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Address Line | 15 WINDSORMERE WAY SUITE 300
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City | OVIEDO
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State | FL
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Zip | 32765-6507
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Country | US
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Telephone | 407-625-5314
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Fax | 186-654-7016
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Provider Business Mailing Address
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Address Line | 15 WINDSORMERE WAY SUITE 300
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City | OVIEDO
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State | FL
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Zip | 32765-6507
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Country | US
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Telephone | 407-625-5314
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Fax | 186-654-7016
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Authorized Official
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Title or Position | DIR
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Name | MRS. AMANDA K SMITH
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Credential | LMHC
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Telephone | 407-625-5314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH9016
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License Number State | FL
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