Healthcare Provider Details

I. General information

NPI: 1932243565
Provider Name (Legal Business Name): PATRICIA DIANNE WHITE MCCLANAHAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA DIANNE FINCHER

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 10/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8476 U S HWY 231 ADMH DIVISION OF INTELLECTUAL DISABILI COMPREHENSIVE SUPPORT SVCS RIV & V
WETUMPKA AL
36092
US

IV. Provider business mailing address

8476 U S HWY 231 ADMH DIVISION OF INTELLECTUAL DISABILI COMPREHENSIVE SUPPORT SVCS RIV & V
WETUMPKA AL
36092
US

V. Phone/Fax

Practice location:
  • Phone: 334-514-4268
  • Fax:
Mailing address:
  • Phone: 334-514-4268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2404
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPENDING
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: