Healthcare Provider Details

I. General information

NPI: 1639683022
Provider Name (Legal Business Name): JOANN ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2017
Last Update Date: 11/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 CANAL ST
NASHUA NH
03064-2886
US

IV. Provider business mailing address

144 CANAL ST
NASHUA NH
03064-2886
US

V. Phone/Fax

Practice location:
  • Phone: 603-459-2795
  • Fax: 603-459-2783
Mailing address:
  • Phone: 603-882-6333
  • Fax: 603-459-2783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-17-30905
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: