Gregory Alexander III
Social Worker, Clinical in Shreveport, LA. Individual provider (NPI-1).
NPI number1770091480
StatusActive
Last updated in NPPESDec 7, 2023
Details
- NPI
- 1770091480
- Entity type
- Individual (NPI-1)
- Name
- Gregory Alexander III
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 16, 2018
- Certification date
- Dec 7, 2023
- Last updated
- Dec 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 17704 | LA | Yes |
Practice location
1310 N Hearne AveShreveport, LA 71107-6516
Phone 318-676-5151
Mailing address
1523 Longbranch AveGrover Beach, CA 93433-2508
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