| NPI | 1053331520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA E FULLER Co Owner 205-838-2031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2011-06-23 |