| Doctor Name: | MRS. AMANDA SMITH |
| NPI Number: | 1013319839 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSS, LCSW, CAADC |
| License Number: | CW017861 |
| Business Practice Address: | 401 Pilgrim Ln Suite 103 Drexel Hill, PA - 190265000 |
| Business Phone Number: | 4844766543 |
| Business Fax Number: | 4844500090 |
| Mailing Address: | 401 Pilgrim Ln, Suite 103 DREXEL HILL |
| State: | PA |
| Postal Code: | 190265000 |
| Phone Number: | 4844766543 |
| Fax Number: | 4844500090 |
| NPI Enumeration Date: | 09/24/2014 |
| NPI Last Update Date: | 09/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | CW017861 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |