Provider Demographics
NPI:1730831579
Name:ESCALANTE, ALICIA SOLIS (MED, BCBA)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:SOLIS
Last Name:ESCALANTE
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4907 AVENUE F APT A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-2518
Mailing Address - Country:US
Mailing Address - Phone:210-542-7877
Mailing Address - Fax:
Practice Address - Street 1:4907 AVENUE F APT A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-2518
Practice Address - Country:US
Practice Address - Phone:210-542-7877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-21-55221103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst