Individual
ALEXANDRA DUVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, SAC-IT
Contact information
Practice address
540 COLLEGE ST, MEDFORD, WI 54451-2027
(715) 748-3332
Mailing address
112 ALLEN ST, ATHENS, WI 54411-9242
(715) 650-1255
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18807
WI
104100000X
Social Worker
131643
WI
1041C0700X
Clinical Social Worker
Primary
9851-123
WI
Other
Enumeration date
07/16/2019
Last updated
10/07/2022
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