Individual
TODD DOUGLAS EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
6110 SHALLOWFORD RD, C O CRC, CHATTANOOGA, TN 37421-1894
(800) 632-6074
(866) 341-7509
Mailing address
PO BOX 10414, LARGO, FL 33773-0414
(800) 632-6074
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3016
NC
103TC0700X
Clinical Psychologist
Primary
P2021
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1345623
BCBS
TN
05
—
6000839
—
NC
Enumeration date
09/14/2006
Last updated
02/13/2008
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