Individual
FRED GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1275 JAMES DR, SUITE A, ENTERPRISE, AL 36330-2063
(334) 347-1862
(334) 308-1942
Mailing address
PO BOX 311062, ENTERPRISE, AL 36331-1062
(334) 347-1862
(334) 308-1942
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
143
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890001970
—
AL
Enumeration date
10/11/2006
Last updated
07/09/2007
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