Provider Demographics
NPI:1164058400
Name:GUZARDO, ALISON ETTER (MT-BC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:ETTER
Last Name:GUZARDO
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 NANCY BETH DR
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-3447
Mailing Address - Country:US
Mailing Address - Phone:281-794-1314
Mailing Address - Fax:
Practice Address - Street 1:721 THOMPSON DR
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5154
Practice Address - Country:US
Practice Address - Phone:830-896-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-18
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09897225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist