Healthcare Provider Details

I. General information

NPI: 1114358942
Provider Name (Legal Business Name): DAPHNE ARNOLD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2013
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 20TH ST S SUITE 101
BIRMINGHAM AL
35205-2610
US

IV. Provider business mailing address

1720 2ND AVE S CH19-307
BIRMINGHAM AL
35294-2041
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-5471
  • Fax: 205-975-2380
Mailing address:
  • Phone: 205-934-1089
  • Fax: 205-975-2380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2817G
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: