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General NPI Number Information
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NPI Number | 1104939610
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Entity Type | Individual
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Provider Name | WILLIAM B MENEESE PHD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/15/2011
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Provider Practice Location Address
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Address Line | 1 W LAKESHORE DR SUITE 201
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City | BIRMINGHAM
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State | AL
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Zip | 35209-0500
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Country | US
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Telephone | 205-602-9980
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Fax | 205-592-8835
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Provider Business Mailing Address
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Address Line | PO BOX 660685
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City | BIRMINGHAM
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State | AL
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Zip | 35266-0685
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Country | US
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Telephone | 205-979-5882
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Fax | 205-979-1248
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 647
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License Number State | AL
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