Provider Demographics
NPI:1932541547
Name:ALVAREZ, MICHELLE MARIE (BS/CJ)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:MARIE
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:BS/CJ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 SALEM DR W
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5225
Mailing Address - Country:US
Mailing Address - Phone:910-389-4419
Mailing Address - Fax:
Practice Address - Street 1:2203 SALEM DR W
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5225
Practice Address - Country:US
Practice Address - Phone:910-389-4419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst