Provider Demographics
NPI:1114178613
Name:SMITH, AMY STEELE (SSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:STEELE
Last Name:SMITH
Suffix:
Gender:F
Credentials:SSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3819 N 1450 W
Mailing Address - Street 2:
Mailing Address - City:HELPER
Mailing Address - State:UT
Mailing Address - Zip Code:84526-2236
Mailing Address - Country:US
Mailing Address - Phone:435-472-0892
Mailing Address - Fax:
Practice Address - Street 1:3819 N 1450 W
Practice Address - Street 2:
Practice Address - City:HELPER
Practice Address - State:UT
Practice Address - Zip Code:84526-2236
Practice Address - Country:US
Practice Address - Phone:435-472-0892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5345505-3503104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker