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General NPI Number Information
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NPI Number | 1083244115
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Entity Type | Individual
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Provider Name | NICK CONIGLIO ALC
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Gender | Male
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Dates
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Enumeration Date | 01/16/2020
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Last Update Date | 01/16/2020
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Provider Practice Location Address
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Address Line | 301 S 8TH ST
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City | OPELIKA
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State | AL
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Zip | 36801-4943
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Country | US
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Telephone | 866-991-6864
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 362084
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City | BIRMINGHAM
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State | AL
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Zip | 35236-2084
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C3445A
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License Number State | AL
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