Individual
DR. RICHARD EDISON BETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3701 LOOP RD, TUSCALOOSA, AL 35404-5015
(205) 554-2000
Mailing address
3701 LOOP RD, TUSCALOOSA, AL 35404-5015
(205) 554-2000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1049
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339037227
—
AL
05
—
339059211
—
AL
01
—
51524235
BLUE CROSS & BLUE SHIELD
AL
01
—
51524272
AMERICAN BEHAVIORAL
AL
Enumeration date
11/28/2006
Last updated
11/21/2012
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