Provider Demographics
NPI:1285485714
Name:ESSEX, ALISSA CORINNE (RBT)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:CORINNE
Last Name:ESSEX
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12175 NETWORK BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3432
Mailing Address - Country:US
Mailing Address - Phone:210-797-7181
Mailing Address - Fax:
Practice Address - Street 1:15656 CLASSEN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-2184
Practice Address - Country:US
Practice Address - Phone:210-797-7181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty