Healthcare Provider Details

I. General information

NPI: 1033636980
Provider Name (Legal Business Name): OLIVIA ANN ALVA M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 08/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 CHERRY RIDGE ST STE D400
SAN ANTONIO TX
78230-4820
US

IV. Provider business mailing address

1019 EL MONTE BLVD
SAN ANTONIO TX
78201-2512
US

V. Phone/Fax

Practice location:
  • Phone: 210-692-0222
  • Fax:
Mailing address:
  • Phone: 210-846-4968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number105917
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: