| NPI | 1467670885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA F. JACKSON Clinic Director 205-348-5003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1322) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |