Provider Demographics
NPI:1255061495
Name:GODINEZ, ALEJANDRO
Entity type:Individual
Prefix:MR
First Name:ALEJANDRO
Middle Name:
Last Name:GODINEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ROWLAND CIR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-3836
Mailing Address - Country:US
Mailing Address - Phone:747-236-9148
Mailing Address - Fax:
Practice Address - Street 1:130 ROWLAND CIR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-3836
Practice Address - Country:US
Practice Address - Phone:747-236-9148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty