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General NPI Number Information
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NPI Number | 1952776510
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Entity Type | Individual
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Provider Name | JESSICA AREVALO
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Gender | Female
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Dates
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Enumeration Date | 12/08/2015
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 1025 MONTGOMERY HWY SUITE 214
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City | VESTAVIA
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State | AL
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Zip | 35216-2845
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Country | US
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Telephone | 205-540-4013
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Fax | 205-822-2732
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Provider Business Mailing Address
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Address Line | 1025 MONTGOMERY HWY SUITE 214
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City | VESTAVIA
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State | AL
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Zip | 35216-2845
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Country | US
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Telephone | 205-540-4013
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Fax | 205-822-2732
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 11518022
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2950
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License Number State | AL
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