Healthcare Provider Details

I. General information

NPI: 1851163000
Provider Name (Legal Business Name): ALYSSON BLUHM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9343 GARLAND RD APT 2120
DALLAS TX
75218-3696
US

IV. Provider business mailing address

9343 GARLAND RD APT 2120
DALLAS TX
75218-3696
US

V. Phone/Fax

Practice location:
  • Phone: 830-477-8632
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: