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Individual

ALYSSA BANHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
13207 WRIGHT RD, BUDA, TX 78610-5000
(512) 697-8600
Mailing address
1016 CAMINO LA COSTA, APT 1901, AUSTIN, TX 78752-3846

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
62525
TX

Other

Enumeration date
07/16/2016
Last updated
07/16/2016
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