Provider Demographics
NPI:1750654273
Name:SMITH, AMBER VASHONN
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:VASHONN
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:VASHONN
Other - Last Name:REECE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9722 OPAL ROCK DR
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-2501
Mailing Address - Country:US
Mailing Address - Phone:713-569-1708
Mailing Address - Fax:
Practice Address - Street 1:9722 OPAL ROCK DR
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-2501
Practice Address - Country:US
Practice Address - Phone:713-569-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool