Doctor Name: | CHARMANE ALVARES |
NPI Number: | 1124151717 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | P1203038 |
Business Practice Address: | 1800 Lindauer Rd Forrest City, AR - 723352404 |
Business Phone Number: | 8704944600 |
Business Fax Number: | |
Mailing Address: | Po Box 2104, SOUTHAVEN |
State: | MS |
Postal Code: | 386710025 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 10/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | P1203038 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |