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NPI Code Detail

MEDICARE: EVETTE DIANE ALVAREZ MS

MEDICARE: EVETTE DIANE ALVAREZ MS
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
1101YM0800XMental Health Counselor12865NE

General Provider Information

NPI Number : 1518618297
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVETTE DIANE ALVAREZ MS
Provider Business Mailing Address
First Line : 11704 ELM ST
Second Line :
City : OMAHA
State : NE
Zip : 68144-4340
Country : US
Telephone Number : 402-637-6137
Fax Number :
Provider Business Practice Location Address
First Line : 4545 DODGE ST
Second Line :
City : OMAHA
State : NE
Zip : 68132-3251
Country : US
Telephone Number : 402-504-3612
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2022
Last Update Date : 01/13/2022

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Directions to “ EVETTE DIANE ALVAREZ MS” Practice Location

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