Provider Demographics
NPI:1225356595
Name:SOUTHWOOD, ELIZABETH ALEXANDRA (MSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ALEXANDRA
Last Name:SOUTHWOOD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-4800
Mailing Address - Country:US
Mailing Address - Phone:317-630-6612
Mailing Address - Fax:
Practice Address - Street 1:1111 W 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-4800
Practice Address - Country:US
Practice Address - Phone:317-630-6612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical