Individual
ALISE THALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2920 W BROAD ST STE 215, RICHMOND, VA 23230-5125
(804) 988-1150
Mailing address
2920 W BROAD ST STE 215, RICHMOND, VA 23230-5125
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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