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 |