Organization
SOURCE FOR CHANGE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA SMALLWOOD (OWNER)
(205) 585-8761
Entity
Organization
Contact information
Practice address
2909 CRESCENT AVE, BIRMINGHAM, AL 35209-2521
(205) 585-8761
Mailing address
2448 WINE RIDGE DR, BIRMINGHAM, AL 35244-2426
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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