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Individual

DR. DEBRA JORDAN PATTERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
813 SHADES CREEK PKWY, SUITE 202A, BIRMINGHAM, AL 35209-4542
(205) 870-5678
Mailing address
813 SHADES CREEK PKWY, SUITE 202A, BIRMINGHAM, AL 35209-4542
(205) 870-5678

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
771
AL
103TC0700X
Clinical Psychologist
Primary
771
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000074849
AL
05
000074851
AL
01
1871667998
TRICARE SOUTH
AL
01
510-74849
BCBS
AL
01
510-74851
BCBS
AL
01
515-02328
FEDERAL BC
AL
Enumeration date
11/20/2006
Last updated
05/12/2010
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