Provider Demographics
NPI:1295468015
Name:WADE, ALEA MORGAN
Entity Type:Individual
Prefix:
First Name:ALEA
Middle Name:MORGAN
Last Name:WADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2743 SMITH RANCH RD UNIT 1202
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5219
Mailing Address - Country:US
Mailing Address - Phone:281-835-4754
Mailing Address - Fax:
Practice Address - Street 1:2743 SMITH RANCH RD UNIT 1202
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5219
Practice Address - Country:US
Practice Address - Phone:281-835-4754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-22-218052106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician