is a Professional in Enterprise, Alabama. practices all healthcare services and medical treatments related to Professional. The NPI Number for is 1609033638. The last update date is .
's current location address is 1311 Rucker Blvd, Enterprise, Alabama. You can contact this provider via phone number 3344170212 and fax number 3344170213. The mailing address for is 1311 Rucker Blvd, Enterprise, Alabama. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1311 Rucker Blvd, Enterprise, Alabama |
| Phone Number | 3344170212 |
| Fax Number | 3344170213 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1609033638 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1311 Rucker Blvd |
|---|---|
| City | Enterprise |
| State | Alabama (AL) |
| Post Code | 363302234 |
| Phone Number | 3344170212 |
| Fax Number | 3344170213 |
Provider's Primary Taxonomy Detail
| Speciality | Professional |
|---|---|
| Taxonomy | 101Yp2500X |
| Licence No | 3621 |
|
Definition: A general counselor who helps people with personal, social, educational, and career issues. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 51549947 | AL | BCBS |
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