Individual
MISS OCTIAVIA SHARNEA MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ALC
Contact information
Practice address
330 OLD HAMBURG RD, UNIONTOWN, AL 36786-2614
(334) 628-2651
(334) 628-2656
Mailing address
415 BARRETT RD, SELMA, AL 36701-6906
(334) 267-9094
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C3432A
—
AL
Enumeration date
11/13/2019
Last updated
11/13/2019
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