Provider Demographics
NPI:1710051974
Name:EUTO, JEWEL ELIZABETH BISHOP (ND,)
Entity Type:Individual
Prefix:DR
First Name:JEWEL
Middle Name:ELIZABETH BISHOP
Last Name:EUTO
Suffix:
Gender:F
Credentials:ND,
Other - Prefix:MRS
Other - First Name:JEWEL
Other - Middle Name:ELIZABETH BISHOP
Other - Last Name:EUTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, LMFT
Mailing Address - Street 1:335 FOWLER ROAD
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35670-6908
Mailing Address - Country:US
Mailing Address - Phone:256-309-7558
Mailing Address - Fax:256-350-8519
Practice Address - Street 1:335 FOWLER ROAD
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:AL
Practice Address - Zip Code:35670-6908
Practice Address - Country:US
Practice Address - Phone:256-309-7558
Practice Address - Fax:256-350-8519
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC#1208101YM0800X, 101YM0800X
ALLMFT#061101YM0800X
174400000X
DCNAT1000348175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes174400000XOther Service ProvidersSpecialist
No175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND100197OtherDOCTOR OF NEDICINE
ALLMFT #061OtherMARRIAGE & FAMILY
ALLPC #1208OtherMENTAL HEALTH
DCNMD #1000348OtherNATUROPATHIC