| NPI | 1265089916 |
|---|---|
| Former Name | AMANDA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL 19776) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2019026437) |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2022-12-13 |