Individual
ALEXANDRIA D LICEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1325 N 63RD ST, WACO, TX 76710-4111
(254) 300-7591
Mailing address
2115 STEPHENS PL STE 400A, NEW BRAUNFELS, TX 78130-2167
(830) 282-7980
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
60219
TX
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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