| NPI | 1407349269 |
|---|---|
| Former Name | AMANDA JANE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361006485) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 1041C0700X Social Worker, Clinical | |
| 3747P1801X Technician, Personal Care Attendant (Licence: MI 6301016613) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2021-04-21 |