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Individual

PHYLLIS B MARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
3504 VANN ROAD, STE 100, GRAYSON & ASSOCIATES PC, BIRMINGHAM, AL 35235
(205) 655-0585
(205) 655-0586
Mailing address
3504 VANN ROAD, STE 100, GRAYSON & ASSOCIATES PC, BIRMINGHAM, AL 35235

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
892
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000034487
AL
01
051034487
BCBS OF AL
AL
Enumeration date
05/31/2006
Last updated
09/19/2016
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