Individual
ALYSSA THALACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9314 RYDER DR, SAN ANTONIO, TX 78254-2000
(210) 447-0039
Mailing address
11660 HUEBNER RD APT 405, SAN ANTONIO, TX 78230-1346
(608) 438-7943
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
RBT-19-102627
TX
Other
Enumeration date
03/02/2020
Last updated
06/28/2022
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