Individual
ALEXA STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2901 INTERLACKEN DR, SPRINGFIELD, IL 62704-4246
(314) 440-5881
Mailing address
2901 INTERLACKEN DR, SPRINGFIELD, IL 62704-4246
(314) 440-5881
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.108029
IL
Other
Enumeration date
07/14/2022
Last updated
09/28/2022
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