Provider Demographics
NPI:1265742654
Name:HANNIG, ALYSSA CATHERINE
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:CATHERINE
Last Name:HANNIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 S 2ND ST
Mailing Address - Street 2:APT. 20
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-1692
Mailing Address - Country:US
Mailing Address - Phone:858-259-5914
Mailing Address - Fax:
Practice Address - Street 1:2014 S 2ND ST
Practice Address - Street 2:APT. 20
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76706-1692
Practice Address - Country:US
Practice Address - Phone:858-259-5914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst