MEDICARE: PAMELA NICOLE ALVAREZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	004618	OH

General Provider Information

NPI Number	:	1083423354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA NICOLE ALVAREZ

Provider Business Mailing Address
First Line	:	6409 SHULL RD
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-1219
Country	:	US
Telephone Number	:	937-580-1666
Fax Number	:

Provider Business Practice Location Address
First Line	:	6409 SHULL RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45424-1219
Country	:	US
Telephone Number	:	937-580-1666
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	01/04/2026

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Directions to “ PAMELA NICOLE ALVAREZ ” Practice Location

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