Healthcare Provider Details

I. General information

NPI: 1255169058
Provider Name (Legal Business Name): DANIELLE ALVARADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8627 CINNAMON CREEK DR STE 701
SAN ANTONIO TX
78240-1482
US

IV. Provider business mailing address

6708 TERRA RYE
SAN ANTONIO TX
78240-2646
US

V. Phone/Fax

Practice location:
  • Phone: 210-680-4747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number86642
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: