Organization Name: | WFR BEHAVIORAL ONE, LLC |
NPI Number: | 1083086052 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM RICHARDSON (OWNER/SCHOOL PSYCHOLOGIST) |
Mailing Address: | 1025 Montgomery Hwy Suite #214 Vestavia |
State: | AL US |
Postal Code: | 352162845 |
Phone Number: | 2052331414 |
Fax Number: | 2058222732 |
NPI Enumeration Date: | 10/29/2015 |
NPI Last Update Date: | 10/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | WXR-01058632 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |