Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 1473 | AL |
NPI | 1013197490 |
---|---|
Provider Name | Dr. Peter Wakefield Winslett |
First Address | Birmingham, AL 35209-6233 |
Second Address | Birmingham, AL 35209-8803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2007 |
Last Update Date | 14/11/2007 |