Provider Demographics
NPI:1164291662
Name:BRATBO, MAYSEN ALVAREZ (MS, GC)
Entity Type:Individual
Prefix:
First Name:MAYSEN
Middle Name:ALVAREZ
Last Name:BRATBO
Suffix:
Gender:F
Credentials:MS, GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 X RAY DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-7491
Mailing Address - Country:US
Mailing Address - Phone:980-834-9638
Mailing Address - Fax:
Practice Address - Street 1:2711 X RAY DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7491
Practice Address - Country:US
Practice Address - Phone:980-834-9638
Practice Address - Fax:980-834-9605
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS