Provider Demographics
NPI:1043745011
Name:ALLISON, ANNETTE C (DSW, LCSW)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:C
Last Name:ALLISON
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-0119
Mailing Address - Country:US
Mailing Address - Phone:832-623-9734
Mailing Address - Fax:
Practice Address - Street 1:525 W WISCONSIN RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3018
Practice Address - Country:US
Practice Address - Phone:956-287-9754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA120531041C0700X
TX650631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical