| NPI | 1043418098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNELLE LEKOYNE WARREN Licensed Psychologist 334-808-8991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1357) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY003090) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2008-04-20 |