Individual
ALYSIA ABIGAIL PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4849 GREENVILLE AVE, DALLAS, TX 75206-4130
(214) 433-6433
Mailing address
4849 GREENVILLE AVE, DALLAS, TX 75206-4130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
81040
TX
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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