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General NPI Number Information
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NPI Number | 1881812048
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Entity Type | Organization
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Legal Business Name | SHEALY & HOLT
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 1613 RICHARD ARRINGTON JR BLVD S
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City | BIRMINGHAM
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State | AL
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Zip | 35205-4952
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Country | US
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Telephone | 205-933-7849
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Fax | 205-933-7880
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Provider Business Mailing Address
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Address Line | 1613 RICHARD ARRINGTON JR BLVD S
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City | BIRMINGHAM
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State | AL
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Zip | 35205-4952
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Country | US
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Telephone | 205-933-7849
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Fax | 205-933-7880
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. BECKY P LANKFORD
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Credential |
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Telephone | 205-933-7849
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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 |
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License Number State | AL
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