Provider Demographics
NPI:1437390853
Name:ALABAMA NEUROBEHAVIOR
Entity Type:Organization
Organization Name:ALABAMA NEUROBEHAVIOR
Other - Org Name:KRISTINE LOKKEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:LOKKEN
Authorized Official - Last Name:EDMONDSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:205-837-3533
Mailing Address - Street 1:321 DELCRIS CT
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35226-1978
Mailing Address - Country:US
Mailing Address - Phone:205-837-3533
Mailing Address - Fax:
Practice Address - Street 1:1025 23RD ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2499
Practice Address - Country:US
Practice Address - Phone:205-837-3533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-14
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1206261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1548290984OtherNPI