Provider Demographics
NPI:1366193039
Name:SAVALA, ALYSON (PHD, MED, BA, LP)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:SAVALA
Suffix:
Gender:F
Credentials:PHD, MED, BA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 DACOMA ST APT 347
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-8765
Mailing Address - Country:US
Mailing Address - Phone:757-345-8428
Mailing Address - Fax:
Practice Address - Street 1:3900 DACOMA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-8709
Practice Address - Country:US
Practice Address - Phone:757-345-8428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39130103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling