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General NPI Number Information
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NPI Number | 1750707253
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Entity Type | Organization
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Legal Business Name | CAPSTONE MEDICAL SOLUTIONS
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 1973 CHANDALAR DR SUITE A
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City | PELHAM
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State | AL
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Zip | 35124-4359
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Country | US
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Telephone | 205-503-1643
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Fax |
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Provider Business Mailing Address
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Address Line | 1973 CHANDALAR DR SUITE C
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City | PELHAM
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State | AL
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Zip | 35124-4359
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Country | US
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Telephone | 205-503-1643
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. SHARON DIANNE WALTZ
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Credential | PSY. D.
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Telephone | 205-503-1643
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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 | 1228
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License Number State | AL
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