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General NPI Number Information
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NPI Number | 1417355504
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 12/05/2014
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Last Update Date | 12/05/2014
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Provider Practice Location Address
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Address Line | 500 SOUTHLAND DRIVE SUITE 109
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City | HOOVER
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State | AL
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Zip | 35226
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Country | US
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Telephone | 205-427-6032
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Fax |
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Provider Business Mailing Address
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Address Line | 500 SOUTHLAND DRIVE SUITE 109
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City | HOOVER
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State | AL
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Zip | 35226
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Country | US
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Telephone | 205-427-6032
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | MISS MARILYN KNIGHT
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Credential | LCSW
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Telephone | 205-427-6032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1140-3596C
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License Number State | AL
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