Provider Demographics
NPI:1518738442
Name:ALVAREZ HERNANDEZ, MADELEYNI N/A (RBT)
Entity type:Individual
Prefix:
First Name:MADELEYNI
Middle Name:N/A
Last Name:ALVAREZ HERNANDEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 PINELAND AVE APT 26
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-6004
Mailing Address - Country:US
Mailing Address - Phone:863-399-5949
Mailing Address - Fax:
Practice Address - Street 1:600 E OGLETHORPE HWY STE B
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-2988
Practice Address - Country:US
Practice Address - Phone:912-667-8730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician