| NPI | 1154754661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON D WALTZ Licensed Clinical Psychologist 205-503-1643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AL 1228) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AL 1228) |
| 101Y00000X Counselor (Licence: AL 1228) | |
| 101YM0800X Counselor, Mental Health (Licence: AL 1228) | |
| 101YP2500X Counselor, Professional (Licence: AL 1228) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: AL 1228) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: AL 1228) | |
| 103TC0700X Psychologist, Clinical (Licence: AL 1228) | |
| 103TC1900X Psychologist, Counseling (Licence: AL 1228) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AL 1228) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: AL 1228) | |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2013-08-20 |