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General NPI Number Information
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NPI Number | 1194332254
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Entity Type | Individual
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Provider Name | VANESSA ILEANN ANDERSON-ALVAREZ BS, BCABA
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Gender | Female
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Dates
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Enumeration Date | 09/23/2020
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 4518 S MANHATTAN AVE
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City | TAMPA
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State | FL
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Zip | 33611-2306
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Country | US
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Telephone | 813-847-8179
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Fax |
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Provider Business Mailing Address
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Address Line | 1565 BLUE MAGNOLIA RD
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City | BRANDON
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State | FL
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Zip | 33510-4029
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Country | US
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Telephone | 813-847-8179
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-25-15914
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License Number State | FL
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