Provider Demographics
NPI:1568600898
Name:TOWNSEND, ALICIA LYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:LYN
Last Name:TOWNSEND
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 1:14479 SONGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-2507
Mailing Address - Country:US
Mailing Address - Phone:817-269-1511
Mailing Address - Fax:
Practice Address - Street 1:14479 SONGBIRD LN
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-2507
Practice Address - Country:US
Practice Address - Phone:817-269-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32687103T00000X, 103TC0700X, 103TE1100X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth