Healthcare Provider Details

I. General information

NPI: 1629017132
Provider Name (Legal Business Name): MARY ANN PLANT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6869 5TH AVENUE SOUTH
BIRMINGHAM AL
35212-1866
US

IV. Provider business mailing address

6869 5TH AVENUE SOUTH
BIRMINGHAM AL
35212-1866
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-2031
  • Fax: 205-838-2031
Mailing address:
  • Phone: 205-838-2031
  • Fax: 205-838-2031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number883
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: