Provider Demographics
NPI:1518585900
Name:SMITH, ALLISON LAURA
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:LAURA
Last Name:SMITH
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 1:8700 STONEBROOK PKWY # 2452
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9998
Mailing Address - Country:US
Mailing Address - Phone:469-609-7644
Mailing Address - Fax:
Practice Address - Street 1:8700 STONEBROOK PKWY UNIT 2452
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6186
Practice Address - Country:US
Practice Address - Phone:469-609-7644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-11
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional