Organization
SANAVITATHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD DALE FALLIN LPCS (OWNER)
(256) 590-2988
Entity
Organization
Contact information
Practice address
2344 VALLEYDALE RD STE B, BIRMINGHAM, AL 35244-2074
(205) 775-7757
Mailing address
2312 MOUNTAIN RUN, BIRMINGHAM, AL 35244-1930
(205) 775-7757
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
512-87016
BCBS
AL
Enumeration date
02/22/2023
Last updated
02/22/2023
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