Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 657 | AL |
Y | 103T00000X | Psychologist | 657 | AL |
NPI | 1003970609 |
---|---|
Provider Name | Dr. Belvia W Matthews |
First Address | Huntsville, AL 35814-1791 |
Second Address | Huntsville, AL 35806-1238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R62888 | (02) | AL |