Healthcare Provider Details

I. General information

NPI: 1013746858
Provider Name (Legal Business Name): ASISTAS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 15TH AVE NW
DECATUR AL
35601-2008
US

IV. Provider business mailing address

21160 ASHLEY BROOK WAY # 58
ELKMONT AL
35620-7008
US

V. Phone/Fax

Practice location:
  • Phone: 256-206-7293
  • Fax:
Mailing address:
  • Phone: 256-206-7293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State

VIII. Authorized Official

Name: FRANCESCA DAMARIS LOCKETT
Title or Position: OWNER
Credential:
Phone: 256-206-7293