Organization
BOARD OF TRUSTEES, UNIVERSITY OF ALABAMA
Active
Other names
UA Autism Spectrum Disorder Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE HAWTHORNE (CREDENTIALING COORDINATOR)
(205) 348-1262
Entity
Organization
Contact information
Practice address
651 5TH AVE E, CDRD ROOM 262, TUSCALOOSA, AL 35401-7424
(205) 348-3130
(205) 348-7216
Mailing address
PO BOX 870360, TUSCALOOSA, AL 35487-0360
(205) 348-3130
(205) 348-7216
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
12/23/2010
Last updated
12/23/2010
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