Individual
MR. LARRY DEAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW, PIP
Contact information
Practice address
2020 PAUL W BRYANT DR, TUSCALOOSA, AL 35401-2312
(205) 752-2504
(205) 345-4842
Mailing address
2779 BIRMINGHAM RD, CENTREVILLE, AL 35042-4640
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1133C
AL
Other
Enumeration date
06/01/2018
Last updated
06/01/2018
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