| NPI | 1639287857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID FETTER Owner/President 205-981-1330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AL 1077) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2011-08-24 |