Healthcare Provider Details

I. General information

NPI: 1093329641
Provider Name (Legal Business Name): ESTEFANIA ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2020
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4909 WATERS EDGE DR
RALEIGH NC
27606-0039
US

IV. Provider business mailing address

4909 WATERS EDGE DR
RALEIGH NC
27606-0039
US

V. Phone/Fax

Practice location:
  • Phone: 919-285-1647
  • Fax:
Mailing address:
  • Phone: 919-285-1647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30004994
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: