Provider Demographics
NPI:1659162642
Name:SANTOS ALVAREZ, TIFFANY NOELLE
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:NOELLE
Last Name:SANTOS ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:NOELLE
Other - Last Name:SANTOS ALVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 271
Mailing Address - Street 2:
Mailing Address - City:ROCKWELL
Mailing Address - State:NC
Mailing Address - Zip Code:28138-0271
Mailing Address - Country:US
Mailing Address - Phone:704-279-0626
Mailing Address - Fax:
Practice Address - Street 1:110 A EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:ROCKWELL
Practice Address - State:NC
Practice Address - Zip Code:28138
Practice Address - Country:US
Practice Address - Phone:704-279-0626
Practice Address - Fax:704-279-0344
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPROVISIONAL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist