Provider Demographics
NPI:1619578614
Name:RISER, NAQUASHA (LPC)
Entity Type:Individual
Prefix:
First Name:NAQUASHA
Middle Name:
Last Name:RISER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 MCNEIL DR APT 623
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-8560
Mailing Address - Country:US
Mailing Address - Phone:901-830-5565
Mailing Address - Fax:
Practice Address - Street 1:9415 MCNEIL DR APT 623
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-8560
Practice Address - Country:US
Practice Address - Phone:901-830-5565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health