Provider Demographics
NPI:1871218388
Name:ALVAREZ, ANAIS M
Entity type:Individual
Prefix:
First Name:ANAIS
Middle Name:M
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 MACK BLVD APT 4
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5674
Mailing Address - Country:US
Mailing Address - Phone:347-576-9415
Mailing Address - Fax:
Practice Address - Street 1:1510 VALLEY CENTER PKWY
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-2267
Practice Address - Country:US
Practice Address - Phone:866-216-2007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA30030679106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician