Provider Demographics
NPI:1043388028
Name:PRESLAR PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:PRESLAR PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:ALVA
Authorized Official - Last Name:PRESLAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:334-444-9217
Mailing Address - Street 1:1312 DENSON DR
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-2914
Mailing Address - Country:US
Mailing Address - Phone:334-737-1537
Mailing Address - Fax:
Practice Address - Street 1:2813 PEPPERELL PKWY
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6125
Practice Address - Country:US
Practice Address - Phone:334-444-9217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL001196103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty