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NPI Code Detail

MEDICARE: ALEXANDRIA BROOKE LEGE

MEDICARE:   ALEXANDRIA BROOKE LEGE
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1881108678
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRIA BROOKE LEGE
Provider Business Mailing Address
First Line : PO BOX 790
Second Line :
City : ASHLAND
State : KY
Zip : 41105-0790
Country : US
Telephone Number : 606-329-8588
Fax Number : 606-329-8195
Provider Business Practice Location Address
First Line : 2165 WINCHESTER AVE
Second Line :
City : ASHLAND
State : KY
Zip : 41101-7745
Country : US
Telephone Number : 606-324-1141
Fax Number : 606-324-2900
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2017
Last Update Date : 02/26/2018

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Directions to “ ALEXANDRIA BROOKE LEGE ” Practice Location

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