Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 34685 | TX |
NPI | 1013593094 |
---|---|
Provider Name | Ms. Amanda L Smith |
First Address | Belton, TX 76513-9200 |
Second Address | Belton, TX 76513-9200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2021 |
Last Update Date | 22/03/2021 |