Most Relevant Information
Provider Data
| NPI Number: | 1003673302 |
| Provider Name: | NATHAN EDWARD POPHAM LCSW, LICSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | CSW007489 |
Most Important Dates
| Enumeration Date: | 03/04/2024 |
| Last Updated: | 03/04/2024 |
Provider Practice Location
308 3RD ST E
FRUITHURST
AL
362623751
Practice Location Phone/Fax
| Phone: | 2569268797 |
| Fax: |
Provider Mailing Location
308 3RD ST E
FRUITHURST
AL
362623751
Provider Mailing Phone/Fax
| Phone: | 2569268797 |
| Fax: |