Provider Demographics
NPI:1891346094
Name:ALFONSO, KATRINA LYNN (MSW, RCSWI)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:LYNN
Last Name:ALFONSO
Suffix:
Gender:F
Credentials:MSW, RCSWI
Other - Prefix:MISS
Other - First Name:KATRINA
Other - Middle Name:LYNN
Other - Last Name:ORDWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4440 MEDALLION DR APT 817
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-1165
Mailing Address - Country:US
Mailing Address - Phone:407-844-7908
Mailing Address - Fax:
Practice Address - Street 1:4440 MEDALLION DR APT 817
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-1165
Practice Address - Country:US
Practice Address - Phone:407-844-7908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor