Healthcare Provider Details

I. General information

NPI: 1396835468
Provider Name (Legal Business Name): LOIS H POPE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 WHITESPORT CIR SW SUITE 2
HUNTSVILLE AL
35801-6444
US

IV. Provider business mailing address

4800 WHITESPORT CIR SW SUITE 2
HUNTSVILLE AL
35801-6444
US

V. Phone/Fax

Practice location:
  • Phone: 256-533-9393
  • Fax: 256-533-9690
Mailing address:
  • Phone: 256-533-9393
  • Fax: 256-533-9690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number737
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number737
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number737
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number737
License Number StateAL
# 5
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number737
License Number StateAL
# 6
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number737
License Number StateAL
# 7
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number737
License Number StateAL
# 8
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number737
License Number StateAL
# 9
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number737
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: