Individual
JEANETTE H MUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
825 RICE MINE RD N, TUSCALOOSA, AL 35406-2314
(205) 391-3099
(205) 391-9793
Mailing address
2868 ACTON RD, BIRMINGHAM, AL 35243-2502
(205) 968-8360
(205) 968-8373
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2053
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51506807
BCBS
AL
Enumeration date
06/28/2006
Last updated
07/08/2007
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