Provider Demographics
NPI:1700597077
Name:ALLEY, BOBBIE JO (LMSW)
Entity type:Individual
Prefix:MS
First Name:BOBBIE
Middle Name:JO
Last Name:ALLEY
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 1:770 N SILVER SPRINGS BLVD APT 1502
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-6094
Mailing Address - Country:US
Mailing Address - Phone:316-559-4431
Mailing Address - Fax:
Practice Address - Street 1:731 N MCLEAN BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4986
Practice Address - Country:US
Practice Address - Phone:316-461-0039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12646104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker