Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 921 | AL |
Y | 103T00000X | Psychologist | 921 | AL |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 921 | AL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 921 | AL |
N | 103G00000X | Clinical Psychologist | 921 | AL |
N | 103TC0700X | Clinical Psychologist | 921 | AL |
N | 103TC1900X | Counseling Psychologist | 921 | AL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 921 | AL |
N | 103TF0000X | Family Psychologist | 921 | AL |
N | 103TF0200X | Forensic Psychologist | 921 | AL |
N | 103TM1800X | Intellectual & Developmental Disabilities | 921 | AL |
N | 103TP2701X | Group Psychotherapist | 921 | AL |
NPI | 1639232283 |
---|---|
Provider Name | Frankie L Preston |
First Address | Huntsville, AL 35801-4335 |
Second Address | Huntsville, AL 35801-4335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 29/04/2008 |