| NPI | 1063057966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN ELIZABETH AYCOCK Credentialing And Billing Specialis 205-968-1227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2019-11-14 |