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NPI 1306394135

NPI 1306394135 : AMANDA SMITH : METAIRIE, LA

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General NPI Number Information
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    NPI Number           |    1306394135
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    Entity Type          |    Individual 
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    Provider Name        |    AMANDA SMITH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/21/2016
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    Last Update Date     |    09/21/2016
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Provider Practice Location Address
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    Address Line         |    6826 VETERANS BLVD APT 232
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    City                 |    METAIRIE
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    State                |    LA
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    Zip                  |    70003-4441
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    Country              |    US
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    Telephone            |    601-392-6300
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 73304 
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    City                 |    METAIRIE
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    State                |    LA
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    Zip                  |    70033-3304
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    
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    License Number State |    
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