MEDICARE: ALANA SUE DUCKWALL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1104070473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALANA SUE DUCKWALL

Provider Business Mailing Address
First Line	:	111 W CENTER ST
Second Line	:
City	:	HARTFORD
State	:	KY
Zip	:	42347-1436
Country	:	US
Telephone Number	:	270-504-0240
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 W CENTER ST
Second Line	:
City	:	HARTFORD
State	:	KY
Zip	:	42347-1436
Country	:	US
Telephone Number	:	270-504-0240
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2008
Last Update Date	:	02/05/2025

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Directions to “ ALANA SUE DUCKWALL ” Practice Location

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