Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 493 | AL |
Y | 103TC0700X | Clinical Psychologist | 493 | AL |
NPI | 1003903725 |
---|---|
Provider Name | Dr. Beverly Bell-Shambley |
First Address | Tuscaloosa, AL 35405-5409 |
Second Address | Tuscaloosa, AL 35401-2929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
510-71210 | BLUECROSS BLUESHIELD (01) | AL |