Healthcare Provider Details

I. General information

NPI: 1629397104
Provider Name (Legal Business Name): CATHERINE CLAYTON PRINCE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2010
Last Update Date: 05/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CORPORATE DR SUITE 125
BIRMINGHAM AL
35242-2941
US

IV. Provider business mailing address

1200 CORPORATE DR SUITE 125
BIRMINGHAM AL
35242-2941
US

V. Phone/Fax

Practice location:
  • Phone: 205-329-7992
  • Fax: 205-329-7999
Mailing address:
  • Phone: 205-329-7992
  • Fax: 205-329-7999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1215
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: