Individual
FERNELLE LEKOYNE WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
889 ELBA HIGHWAY, SUITE 107A, TROY, AL 36079-6017
(334) 808-8991
(334) 808-8995
Mailing address
PO BOX 952, TROY, AL 36081-0952
(334) 434-9019
(334) 808-8995
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1357
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51532779
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/07/2006
Last updated
07/08/2007
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