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General NPI Number Information
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NPI Number | 1750424768
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Entity Type | Individual
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Provider Name | JACALYN G TIPPEY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 8739 INVERNESS PL
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City | TUSCALOOSA
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State | AL
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Zip | 35405-8958
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Country | US
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Telephone | 205-242-7075
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Fax | 205-758-4310
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Provider Business Mailing Address
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Address Line | 8739 INVERNESS PL
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City | TUSCALOOSA
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State | AL
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Zip | 35405-8958
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Country | US
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Telephone | 205-242-7075
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Fax | 205-758-4310
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2155
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License Number State | AL
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