Provider Demographics
NPI:1144865460
Name:RICHARDSON, ALZELDA (PHD)
Entity type:Individual
Prefix:DR
First Name:ALZELDA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ALZELDA
Other - Middle Name:
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2517 CENTER POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35215-2548
Mailing Address - Country:US
Mailing Address - Phone:205-746-4601
Mailing Address - Fax:205-744-7204
Practice Address - Street 1:2517 CENTER POINT PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35215-2548
Practice Address - Country:US
Practice Address - Phone:205-746-4601
Practice Address - Fax:205-744-7204
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2466101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional