Provider Demographics
NPI:1043037229
Name:ALVARADO, MARIAH (BCBA)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 GREELEY AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2411
Mailing Address - Country:US
Mailing Address - Phone:347-554-1272
Mailing Address - Fax:
Practice Address - Street 1:5105 BUR OAK CIR FL 2
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-3160
Practice Address - Country:US
Practice Address - Phone:347-554-1272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-24-74173103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst