Doctor Name: | DR. ANNETTE P BOHANNON |
NPI Number: | 1023365608 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ED.D. |
License Number: | 2497 |
Business Practice Address: | 393 Green St Alexander City, AL - 350101407 |
Business Phone Number: | 2563293002 |
Business Fax Number: | 2563296598 |
Mailing Address: | 393 Green St, ALEXANDER CITY |
State: | AL |
Postal Code: | 350101407 |
Phone Number: | 2563293002 |
Fax Number: | 2563296598 |
NPI Enumeration Date: | 08/13/2012 |
NPI Last Update Date: | 08/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2497 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |