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Individual

ALEXIS M SHOUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
224 COLUMBUS RD, ATHENS, OH 45701-1334
(740) 592-6720
(740) 592-6729
Mailing address
224 COLUMBUS RD, ATHENS, OH 45701-1334
(740) 592-6724
(740) 592-6728

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1201194
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2314525
OH
05
2864002
OH
Enumeration date
04/19/2018
Last updated
06/16/2018
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