Provider Demographics
NPI:1568897536
Name:CORTNEY ALVAREZ
Entity Type:Organization
Organization Name:CORTNEY ALVAREZ
Other - Org Name:KNEADED THOUGHTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/COUNSELOR/MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CORTNEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LLPC,LMT
Authorized Official - Phone:989-573-8225
Mailing Address - Street 1:8976 KOCHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-9671
Mailing Address - Country:US
Mailing Address - Phone:989-573-8225
Mailing Address - Fax:
Practice Address - Street 1:8976 KOCHVILLE RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-9671
Practice Address - Country:US
Practice Address - Phone:989-573-8225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015264101YP2500X, 101YP2500X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty