Doctor Name: | AIKO OBUCHI |
NPI Number: | 1134378995 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2661 |
Business Practice Address: | 19815 Bay Branch Rd Andalusia, AL - 364209234 |
Business Phone Number: | 3342222525 |
Business Fax Number: | 3342224660 |
Mailing Address: | 19815 Bay Branch Rd, ANDALUSIA |
State: | AL |
Postal Code: | 364209234 |
Phone Number: | 3342222525 |
Fax Number: | 3342224660 |
NPI Enumeration Date: | 09/16/2008 |
NPI Last Update Date: | 09/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2661 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |