MEDICARE: MARIA DE JESUS ALONSO GIL LMSW

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	2025013172	MO

General Provider Information

NPI Number	:	1821981465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA DE JESUS ALONSO GIL LMSW

Provider Business Mailing Address
First Line	:	5781 MAYBERRY LN
Second Line	:
City	:	PARK HILLS
State	:	MO
Zip	:	63601-8174
Country	:	US
Telephone Number	:	573-330-6390
Fax Number	:

Provider Business Practice Location Address
First Line	:	1286 MATTHEWS LN
Second Line	:
City	:	PARK HILLS
State	:	MO
Zip	:	63601-7207
Country	:	US
Telephone Number	:	573-562-7751
Fax Number	:

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

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	06/02/2025

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