| Doctor Name: | AMY SUE SMITH |
| NPI Number: | 1023475761 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 6401004469 |
| Business Practice Address: | 3111 Electric Ave Port Huron, MI - 480608127 |
| Business Phone Number: | 8109667830 |
| Business Fax Number: | 8109857620 |
| Mailing Address: | 3111 Electric Ave, PORT HURON |
| State: | MI |
| Postal Code: | 480608127 |
| Phone Number: | 8109667830 |
| Fax Number: | 8109857620 |
| NPI Enumeration Date: | 01/26/2016 |
| NPI Last Update Date: | 01/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401004469 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |