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Individual

ALEXANDER DUVALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
513 MADISON AVE, COVINGTON, KY 41011-1562
(859) 331-3292
(859) 578-2864
Mailing address
502 FARRELL DRIVE, C/O DEANA COMBS, COVINGTON, KY 41011
(859) 578-3204
(859) 578-3273

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5082015
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
610661458
TAX ID
KY
Enumeration date
07/30/2015
Last updated
07/30/2015
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