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Contact Information

EAST ALABAMA CENTER FOR CHANGE, LLC
124 BRAGG AVE
AUBURN, AL36830-3809
 Phone: 334-734-2603
 Fax: 334-887-0031
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Health

103TH0004X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for EAST ALABAMA CENTER FOR CHANGE LLC · (Female)

NPI # 1902280126
Status Active
Credentials
Entity Individual
Enumeration date 07/17/2015
Last updated 07/17/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • AL License # AL1749
  • AL Other 102I626774 MEDICARE PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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