Provider Demographics
NPI:1760590442
Name:DRYER, ARLENE G (LCSW)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:G
Last Name:DRYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 SHADOW CLIFF ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4009
Mailing Address - Country:US
Mailing Address - Phone:210-494-8016
Mailing Address - Fax:
Practice Address - Street 1:JFCS, 12500 N.W. MILITARY HWY.
Practice Address - Street 2:#250
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231
Practice Address - Country:US
Practice Address - Phone:210-302-6920
Practice Address - Fax:210-302-6952
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81189WMedicare ID - Type Unspecified