Healthcare Provider Details

I. General information

NPI: 1194810499
Provider Name (Legal Business Name): ARISTA DIANNE RAYFIELD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 04/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVENUE SOUTH SUITE 500 ACC BUILDING
BIRMINGHAM AL
35233
US

IV. Provider business mailing address

1600 7TH AVENUE SOUTH SUITE 500 ACC BUILDING
BIRMINGHAM AL
35233
US

V. Phone/Fax

Practice location:
  • Phone: 205-939-9193
  • Fax: 205-939-9949
Mailing address:
  • Phone: 205-939-9193
  • Fax: 205-939-9949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1146
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1146
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: