Individual
MR. JEFFERY DANIEL DUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD. LPC MAC NCC
Contact information
Practice address
1615 KATHY LN SW, DECATUR, AL 35603-1026
(256) 306-4141
(306) 301-3891
Mailing address
1615 KATHY LN SW, PO BX 2239, DECATUR, AL 35603-1026
(256) 306-4141
(306) 301-3891
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2290
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-26338
BLUE CROSS
AL
Enumeration date
10/03/2006
Last updated
07/08/2007
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