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ALICIA SUTTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPS

Contact information

Practice address
8009 SMOKE CREEK LN, TEMPLE, TX 76502-4143
(314) 518-1188
Mailing address
8009 SMOKE CREEK LN, TEMPLE, TX 76502-4143
(314) 518-1188

Taxonomy

Speciality
Code
Description
License number
State
174200000X
Meals Provider
TX
175T00000X
Peer Specialist
Primary
11674
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306198411
MO
Enumeration date
10/12/2012
Last updated
04/20/2026
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