| Doctor Name: | DR. JOANNA T KOULIANOS |
| NPI Number: | 1013193010 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 1453 |
| Business Practice Address: | 22 N Florida St Mobile, AL - 366073108 |
| Business Phone Number: | 2516542429 |
| Business Fax Number: | 2514700409 |
| Mailing Address: | 1956 S University Blvd Ste J, Pmb 196 MOBILE |
| State: | AL |
| Postal Code: | 366092928 |
| Phone Number: | 2516542429 |
| Fax Number: | |
| NPI Enumeration Date: | 01/21/2008 |
| NPI Last Update Date: | 09/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 1453 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |