| Cbphd Llc | |
|
112 Blakeney Ave Fairhope AL 36532-2508 | |
| (251) 753-8587 | |
| Not Available |
| Full Name | Cbphd Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 112 Blakeney Ave, Fairhope, Alabama |
| Authorized Official Name and Position | Cathy Jean Brumback (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 2517538587 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cbphd Llc Po Box 421 Fairhope AL 36533-0421 Ph: (251) 753-8587 | Cbphd Llc 112 Blakeney Ave Fairhope AL 36532-2508 Ph: (251) 753-8587 |
| NPI Number | 1497595763 |
|---|---|
| Provider Enumeration Date | 05/25/2024 |
| Last Update Date | 05/25/2024 |
| Certification Date | 05/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497595763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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