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General NPI Number Information
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NPI Number | 1437330743
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Entity Type | Individual
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Provider Name | LAILI J RADPOUR-MARKERT PHD
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Gender | Female
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 712 29TH ST S SUITE B-2
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City | BIRMINGHAM
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State | AL
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Zip | 35233-2810
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Country | US
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Telephone | 205-908-2456
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Fax | 866-469-3880
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Provider Business Mailing Address
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Address Line | 4416 CLAIRMONT AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35222-3728
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Country | US
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Telephone | 205-908-2456
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Fax | 866-469-3880
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1007
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License Number State | AL
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