Provider Demographics
NPI:1215065412
Name:HARTFIELD, ALISA L (LBSW)
Entity type:Individual
Prefix:MISS
First Name:ALISA
Middle Name:L
Last Name:HARTFIELD
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9010 SAINT JULIEN CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3538
Mailing Address - Country:US
Mailing Address - Phone:210-682-6530
Mailing Address - Fax:210-682-3530
Practice Address - Street 1:9010 SAINT JULIEN CT
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3538
Practice Address - Country:US
Practice Address - Phone:210-682-6530
Practice Address - Fax:210-682-3530
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40197171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator