Provider Demographics
NPI:1639189400
Name:MAIO, JOSEPH E (PHD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:MAIO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 MCFARLAND BLVD E STE F
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5820
Mailing Address - Country:US
Mailing Address - Phone:205-758-7710
Mailing Address - Fax:205-758-3969
Practice Address - Street 1:2110 MCFARLAND BLVD E STE F
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5820
Practice Address - Country:US
Practice Address - Phone:205-758-7710
Practice Address - Fax:205-758-3969
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL615103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALR36199Medicare UPIN