Healthcare Provider Details

I. General information

NPI: 1275260416
Provider Name (Legal Business Name): HALEY LYNN OBERHOLZER ALC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2022
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2129 RICHARD ARRINGTON JR BLVD S
BIRMINGHAM AL
35209-1256
US

IV. Provider business mailing address

3083 ALTALOMA CV
VESTAVIA HILLS AL
35216-4212
US

V. Phone/Fax

Practice location:
  • Phone: 205-732-7200
  • Fax:
Mailing address:
  • Phone: 205-732-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC05337
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: