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General NPI Number Information
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NPI Number | 1992011514
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Entity Type | Individual
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Provider Name | ALEXA K WALDMANN CSW INTERN
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Gender | Female
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 150 RIDGE ST
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City | RENO
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State | NV
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Zip | 89501-1986
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Country | US
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Telephone | 775-223-1009
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Fax | 775-364-7032
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Provider Business Mailing Address
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Address Line | 62 S MADDUX DR
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City | RENO
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State | NV
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Zip | 89512-1831
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Country | US
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Telephone | 775-223-1009
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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 | 5398-S
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License Number State | NV
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