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General NPI Number Information
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NPI Number | 1669343398
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Entity Type | Individual
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Provider Name | ELISA ALVAREZ MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 76 WILLIAMS ST
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City | PONTIAC
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State | MI
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Zip | 48341-1756
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Country | US
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Telephone | 248-230-9652
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Fax |
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Provider Business Mailing Address
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Address Line | 24445 NORTHWESTERN HWY STE 200
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2437
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Country | US
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Telephone | 855-882-2736
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6851120980
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License Number State | MI
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