Organization
ALAN D BLOTCKY PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN BLOTCKY PHD (OWNER)
(205) 912-7171
Entity
Organization
Contact information
Practice address
529 BEACON PKWY W STE 107, BIRMINGHAM, AL 35209-3126
(205) 912-7171
Mailing address
973 VIRIDIAN WAY, BIRMINGHAM, AL 35226-2810
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430
LICENSE
AL
Enumeration date
04/24/2020
Last updated
04/29/2020
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