Healthcare Provider Details

I. General information

NPI: 1922290204
Provider Name (Legal Business Name): ALVINA JEAN TSOSIE M. ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 08/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 61 BOX 40
TEEC NOS POS AZ
86514-9600
US

IV. Provider business mailing address

HC 61 BOX 40
TEEC NOS POS AZ
86514-9600
US

V. Phone/Fax

Practice location:
  • Phone: 928-656-4188
  • Fax: 928-656-4178
Mailing address:
  • Phone: 928-656-4188
  • Fax: 928-656-4178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: