Provider Demographics
NPI:1548570021
Name:ZALOT, ALECIA A (PHD)
Entity Type:Individual
Prefix:
First Name:ALECIA
Middle Name:A
Last Name:ZALOT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 S NEW BRAUNFELS AVE
Mailing Address - Street 2:STE. 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-3005
Mailing Address - Country:US
Mailing Address - Phone:210-532-8811
Mailing Address - Fax:210-531-8172
Practice Address - Street 1:6711 S NEW BRAUNFELS AVE
Practice Address - Street 2:STE. 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3005
Practice Address - Country:US
Practice Address - Phone:210-532-8811
Practice Address - Fax:210-531-8172
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34917103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34917OtherSTATE PROFESSIONAL LICENSE