| NPI | 1639340904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA L MCGOUGH Billing Director 256-705-4405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 895) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2008-03-14 |