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Individual

MRS. ALISA BROOKE SUMNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 412-3247
Mailing address
PO BOX 614, HOPKINSVILLE, KY 42240-1626
(270) 886-2205
(270) 886-0392

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3547
KY
1041C0700X
Clinical Social Worker
3547
KY
1041C0700X
Clinical Social Worker
5195
KY
1041S0200X
School Social Worker

Other

Enumeration date
08/06/2007
Last updated
09/11/2023
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