Healthcare Provider Details

I. General information

NPI: 1568897536
Provider Name (Legal Business Name): CORTNEY ALVAREZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2013
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8976 KOCHVILLE RD
SAGINAW MI
48603-9671
US

IV. Provider business mailing address

8976 KOCHVILLE RD
SAGINAW MI
48603-9671
US

V. Phone/Fax

Practice location:
  • Phone: 989-573-8225
  • Fax:
Mailing address:
  • Phone: 989-573-8225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401015264
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: CORTNEY A ALVAREZ
Title or Position: OWNER/COUNSELOR/MASSAGE THERAPIST
Credential: LLPC,LMT
Phone: 989-573-8225