Individual
MRS. ALEXIS MICHAEL GULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
25 BEACHWAY DR, SUITE C, INDIANAPOLIS, IN 46224-8506
(317) 788-4111
Mailing address
7334 HARBOUR ISLE, INDIANAPOLIS, IN 46240-3471
(801) 694-3836
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005217A
IN
1041C0700X
Clinical Social Worker
379250-3501
UT
Other
Enumeration date
03/20/2007
Last updated
04/28/2008
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