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General NPI Number Information
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NPI Number | 1427603117
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Entity Type | Organization
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Legal Business Name | ALABAMA TESTING AND LEARNING CENTER, LLC
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 08/08/2019
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Provider Practice Location Address
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Address Line | 3499 INDEPENDENCE DR STE 111
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City | HOMEWOOD
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State | AL
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Zip | 35209-5665
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Country | US
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Telephone | 205-848-2750
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Fax |
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Provider Business Mailing Address
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Address Line | 2093 KIRKMAN DR
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City | BIRMINGHAM
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State | AL
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Zip | 35242-4639
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Country | US
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Telephone | 205-542-7120
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. BRANDON DEAREN
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Credential | PSY.D.
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Telephone | 205-542-7120
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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