Provider Demographics
NPI:1609374123
Name:LAW, ALYSON
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:LAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALYSON
Other - Middle Name:
Other - Last Name:ZOLLINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1621 W WALNUT HILL LN
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1621 W WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-3704
Practice Address - Country:US
Practice Address - Phone:801-319-5655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator