Provider Demographics
NPI:1093047979
Name:ALVARADO, MARTA M (PSY D)
Entity Type:Individual
Prefix:MS
First Name:MARTA
Middle Name:M
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HV26 CALLE 240
Mailing Address - Street 2:COUNTRY CLUB
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982-2738
Mailing Address - Country:US
Mailing Address - Phone:787-769-4548
Mailing Address - Fax:
Practice Address - Street 1:HV26 CALLE 240
Practice Address - Street 2:COUNTRY CLUB
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2738
Practice Address - Country:US
Practice Address - Phone:787-769-4548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3494103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical