Individual
ALEXA BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33005496A
IN
1041C0700X
Clinical Social Worker
Primary
34006719A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000841425
ANTHEM BCBS
IN
01
—
000000843959
ANTHEM BCBS
IN
Enumeration date
11/15/2010
Last updated
11/04/2020
Update your record
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