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NPI Code Detail

MEDICARE: JOSELINE VIDAL ALVAREZ M.A.

MEDICARE: JOSELINE VIDAL ALVAREZ M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1497234405
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSELINE VIDAL ALVAREZ M.A.
Provider Business Mailing Address
First Line : 27777 INKSTER RD
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48334-5310
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 7770 E WRIGHTSTOWN RD
Second Line :
City : TUCSON
State : AZ
Zip : 85715-4330
Country : US
Telephone Number : 855-772-8847
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2018
Last Update Date : 07/09/2024

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