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General NPI Number Information
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NPI Number | 1376928663
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Entity Type | Organization
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Legal Business Name | ANNE ROSE ALVE
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Dates
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Enumeration Date | 07/28/2015
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 6913 EGAN WAY
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City | FORT WORTH
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State | TX
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Zip | 76137-1656
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Country | US
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Telephone | 469-422-3790
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Fax |
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Provider Business Mailing Address
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Address Line | 6913 EGAN WAY
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City | FORT WORTH
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State | TX
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Zip | 76137-1656
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTITIONER
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Name | ANNE ROSE ALVE
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Credential | LCSW, LCDC
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Telephone | 469-422-3790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 56596
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License Number State | TX
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