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General NPI Number Information
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NPI Number | 1235713819
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Entity Type | Individual
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Provider Name | LEXIE MARIE TRUDEAU MSW
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Gender | Female
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 6744 FLINTWOOD ST
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City | NAVARRE
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State | FL
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Zip | 32566-8694
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Country | US
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Telephone | 603-521-4813
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Fax |
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Provider Business Mailing Address
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Address Line | 2131 S EASTGATE AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65809-2146
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Country | US
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Telephone | 855-755-3797
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ISW13743
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License Number State | FL
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