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General NPI Number Information
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NPI Number | 1750056248
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Entity Type | Individual
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Provider Name | ALEXIS SAMPRATT EARLY LCSW, ACM-SW
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Gender | Female
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Dates
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Enumeration Date | 08/16/2021
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 1201 E 9TH STREET DOMICILLARY
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City | BONHAM
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State | TX
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Zip | 75418
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Country | US
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Telephone | 800-924-8387
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Fax |
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Provider Business Mailing Address
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Address Line | 8402 TURNBERRY ST
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City | ROWLETT
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State | TX
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Zip | 75089-8325
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Country | US
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Telephone | 214-968-1833
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 32933
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License Number State | TX
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