Provider Demographics
NPI:1699806984
Name:ALONSO, ELIZABETH KAY (BS)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:KAY
Last Name:ALONSO
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:KAY
Other - Last Name:CLEAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:321 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-3132
Mailing Address - Country:US
Mailing Address - Phone:931-490-1437
Mailing Address - Fax:931-490-1404
Practice Address - Street 1:321 W 7TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3132
Practice Address - Country:US
Practice Address - Phone:931-490-1437
Practice Address - Fax:931-490-1404
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator