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1316179005
AMANDA R SMITH
MEDFORD, OR
NPI
1316179005
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Former Name
AMANDA R BUSSONE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2009-08-14
Last Update Date
2022-11-03
Business Address
AMANDA R SMITH MS
200 BEATTY ST
MEDFORD, OR 97501-5811
Phone number: 541-476-2373
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Mailing Address
AMANDA R SMITH MS
1215 SW G ST # 97526
GRANTS PASS, OR 97526-2544
Phone number: 541-476-2373
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