Basic Information
| Provider Information | |||||||||
| NPI: | 1235355504 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALVILLAR | ||||||||
| FirstName: | JANICE | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | LISW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3100 OAK ST | ||||||||
| Address2: | |||||||||
| City: | LAS CRUCES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880053425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5759935225 | ||||||||
| FaxNumber: | 5756524163 | ||||||||
| Practice Location | |||||||||
| Address1: | 1320 S SOLANO DR | ||||||||
| Address2: | |||||||||
| City: | LAS CRUCES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880013758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5055561656 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 11/22/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I-4324 | NM | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.