Individual
DR. ALLEN R STATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LCSW (PIP) ACSW
Contact information
Practice address
104 EDWARDS DRIVE, MARION, AL 36756
(334) 815-2100
(334) 683-4114
Mailing address
1017 MEDICAL CENTER PARKWAY, SELMA, AL 36701
(334) 875-2100
(334) 418-6540
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2235C
AL
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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