Provider Demographics
NPI:1831340819
Name:ADULT LEARNING EVALUATION CENTER
Entity type:Organization
Organization Name:ADULT LEARNING EVALUATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL INSTRUCTION
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVE
Authorized Official - Middle Name:E,
Authorized Official - Last Name:WETTSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:850-644-4838
Mailing Address - Street 1:1114 WEST CALL STREET
Mailing Address - Street 2:214 STONE BUILDING, FLORIDA STATE UNIVERSITY
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32306-4453
Mailing Address - Country:US
Mailing Address - Phone:850-644-3611
Mailing Address - Fax:850-645-3308
Practice Address - Street 1:1114 WEST CALL STREET
Practice Address - Street 2:214 STONE BUILDING, FLORIDA STATE UNIVERSITY
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32306-4453
Practice Address - Country:US
Practice Address - Phone:850-644-3611
Practice Address - Fax:850-645-3308
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA STATE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6123103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty