Provider Demographics
NPI:1558867754
Name:ALVAREZ, ASHLEY NAIR
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NAIR
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 4 BOX 4394
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-8928
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21 CALLE 2
Practice Address - Street 2:URB JARDINES DE DIVERSILANDIA
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-8928
Practice Address - Country:US
Practice Address - Phone:787-914-4796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR230401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty