| NPI | 1346658796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA A GRESSARD Clinical Psychologis 334-489-4448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1725) |
| Additional Taxonomies | 251S00000X (Licence: AL 1725) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-11-24 |