| NPI | 1639426729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE BETHKE STOLL Clinical Psychologist 205-414-6686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AL 1404) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AL 11211750) |
| 103K00000X Behavior Analyst (Licence: AL 1106821) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AL 1715) | |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2012-08-08 |