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General NPI Number Information
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NPI Number | 1831340819
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Entity Type | Organization
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Legal Business Name | ADULT LEARNING EVALUATION CENTER
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 10/08/2008
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Provider Practice Location Address
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Address Line | 1114 WEST CALL STREET 214 STONE BUILDING, FLORIDA STATE UNIVERSITY
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City | TALLAHASSEE
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State | FL
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Zip | 32306-4453
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Country | US
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Telephone | 850-644-3611
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Fax | 850-645-3308
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Provider Business Mailing Address
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Address Line | 1114 WEST CALL STREET 214 STONE BUILDING, FLORIDA STATE UNIVERSITY
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City | TALLAHASSEE
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State | FL
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Zip | 32306-4453
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Country | US
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Telephone | 850-644-3611
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Fax | 850-645-3308
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL INSTRUCTION
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Name | MRS. EVE E, WETTSTEIN
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Credential | ED.S
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Telephone | 850-644-4838
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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 | PY6123
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License Number State | FL
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