Provider Demographics
NPI:1528622784
Name:ALVAREZ, INNA (BCBA)
Entity type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:ALVAREZ
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 1:6980 NW 186TH ST APT 524
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-8307
Mailing Address - Country:US
Mailing Address - Phone:786-458-4464
Mailing Address - Fax:
Practice Address - Street 1:11401 SW 40TH ST STE 304
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3339
Practice Address - Country:US
Practice Address - Phone:786-907-4925
Practice Address - Fax:786-907-4972
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-55379103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst