Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 3231 | KY |
NPI | 1003069519 |
---|---|
Provider Name | Gina M Alexander |
First Address | Danville, KY 40423-0990 |
Second Address | Danville, KY 40422-2527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 28/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3231 | LICENSE # (01) | KY |