Healthcare Provider Details

I. General information

NPI: 1205847100
Provider Name (Legal Business Name): CAROL JEAN DASHIFF R.N., L.M.F.T.; PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1600 CARRAWAY BLVD
BIRMINGHAM AL
35234-1913
US

IV. Provider business mailing address

4529 S SHADES CREST RD
BESSEMER AL
35022-4206
US

V. Phone/Fax

Practice location:
  • Phone: 205-502-5089
  • Fax:
Mailing address:
  • Phone: 205-428-1160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT 252
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: