| Organization Name: | UNIVERSITY OF ALABAMA AT BIRMINGHAM |
| NPI Number: | 1144235870 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VALERIE JOHNSON (ADMINISTRATOR/BUSINESS OFFICER) |
| Mailing Address: | 1023 Medical Center Pkwy Suite 200 Selma |
| State: | AL US |
| Postal Code: | 367016780 |
| Phone Number: | 3348754184 |
| Fax Number: | 3348743511 |
| NPI Enumeration Date: | 07/30/2006 |
| NPI Last Update Date: | 06/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |