| East Alabama Center For Change, Llc | |
|
124 Bragg Ave Auburn AL 36830-3809 | |
| (334) 734-2603 | |
| (334) 887-0031 |
| Full Name | East Alabama Center For Change, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 124 Bragg Ave, Auburn, Alabama |
| Authorized Official Name and Position | Amber Elizabeth Douglas (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 3347342603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Alabama Center For Change, Llc 124 Bragg Ave Auburn AL 36830-3809 Ph: (334) 734-2603 | East Alabama Center For Change, Llc 124 Bragg Ave Auburn AL 36830-3809 Ph: (334) 734-2603 |
| NPI Number | 1902280126 |
|---|---|
| Provider Enumeration Date | 07/17/2015 |
| Last Update Date | 07/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902280126 | NPI | - | NPPES |
| 102I626774 | Other | AL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | AL1749 (Alabama) | Primary |
| 103TH0004X | Psychologist - Health | AL1749 (Alabama) | Secondary |
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