Provider Demographics
NPI:1154970887
Name:QUINTANA, ALEJANDRA (LMSW)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 E GREGORY BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1323
Mailing Address - Country:US
Mailing Address - Phone:575-202-5054
Mailing Address - Fax:
Practice Address - Street 1:3737 S ELIZABETH ST STE 100
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1785
Practice Address - Country:US
Practice Address - Phone:816-255-1501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190319911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical