Healthcare Provider Details

I. General information

NPI: 1073175907
Provider Name (Legal Business Name): MARIA E ALVAREZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 07/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ALCALDE PL SW UNIT 7C
ALBUQUERQUE NM
87104-1036
US

IV. Provider business mailing address

600 ALCALDE PL SW UNIT 7C
ALBUQUERQUE NM
87104-1036
US

V. Phone/Fax

Practice location:
  • Phone: 505-203-0599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARIA ELENA ALVAREZ
Title or Position: LPCC
Credential:
Phone: 505-203-0599