| NPI | 1689792772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JEFFERY BOLL Director 205-868-2090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AL 386) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |