Healthcare Provider Details

I. General information

NPI: 1912956343
Provider Name (Legal Business Name): NANCY S BERLAND PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 LAKESHORE DRIVE STE 150 GRAYSON ASSOCIATES PC
BIRMINGHAM AL
35209
US

IV. Provider business mailing address

2200 LAKESHORE DRIVE STE 150 GRAYSON ASSOCIATES PC
BIRMINGHAM AL
35209
US

V. Phone/Fax

Practice location:
  • Phone: 205-871-6926
  • Fax: 205-871-7981
Mailing address:
  • Phone: 205-871-6926
  • Fax: 205-871-7981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number389
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: