Organization
COMPREHENSIVE THERAPUETIC ASSESSMENTS AND COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUDOLPH MARTIN NCC, LPC (CLINICAL DIRECTOR)
(334) 614-0959
Entity
Organization
Contact information
Practice address
915 12TH ST, PHENIX CITY, AL 36867-5821
(334) 614-0959
Mailing address
915 12TH ST, PHENIX CITY, AL 36867-5821
(334) 614-0959
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2786
AL
251S00000X
Community/Behavioral Health Agency
LPC005656
GA
Other
Enumeration date
03/18/2011
Last updated
03/18/2011
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