Healthcare Provider Details

I. General information

NPI: 1225171671
Provider Name (Legal Business Name): JENNIFER LYNN ADAMS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6341 PICCADILLY SQUARE DR
MOBILE AL
36609-5103
US

IV. Provider business mailing address

15360 CLARK RD
CODEN AL
36523-3206
US

V. Phone/Fax

Practice location:
  • Phone: 251-343-5300
  • Fax: 251-343-6613
Mailing address:
  • Phone: 251-824-8602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1599
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number1599
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: