Provider Demographics
NPI:1437361110
Name:ALVAREZ, HEATHER KRISHNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:KRISHNA
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 GROVEVILLE ROAD
Mailing Address - Street 2:SEBAGO EDUCATIONAL ALLIANCE
Mailing Address - City:BUXTON
Mailing Address - State:ME
Mailing Address - Zip Code:04093
Mailing Address - Country:US
Mailing Address - Phone:207-727-9100
Mailing Address - Fax:
Practice Address - Street 1:24 GROVEVILLE ROAD
Practice Address - Street 2:SEBAGO EDUCATIONAL ALLIANCE
Practice Address - City:BUXTON
Practice Address - State:ME
Practice Address - Zip Code:04093
Practice Address - Country:US
Practice Address - Phone:207-727-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS1245103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist