Individual
DR. JAMES PRESTON GARDEPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
915 WILLOWBROOK DR SE, SUITE C, HUNTSVILLE, AL 35802-3262
(256) 882-2004
Mailing address
915 WILLOWBROOK DR SE, SUITE C, HUNTSVILLE, AL 35802-3262
(256) 882-2004
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
523
AL
103TB0200X
Cognitive & Behavioral Psychologist
523
AL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
523
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000074448
—
AL
01
—
510-74448GAR
BCBS OF ALABAMA
AL
05
—
529400650
—
AL
Enumeration date
03/09/2007
Last updated
03/16/2010
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