Healthcare Provider Details

I. General information

NPI: 1518055656
Provider Name (Legal Business Name): PDSS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 NOBLE ST
ANNISTON AL
36201-3214
US

IV. Provider business mailing address

1910 NOBLE ST
ANNISTON AL
36201-3214
US

V. Phone/Fax

Practice location:
  • Phone: 256-238-0451
  • Fax: 256-238-0446
Mailing address:
  • Phone: 256-238-0451
  • Fax: 256-238-0446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. ROSETTA SHARP DEAN
Title or Position: OWNER/CEO
Credential: ED.D.
Phone: 256-238-0451