Individual
DR. CHARISSA C CAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., ABPP
Contact information
Practice address
6263 POPLAR AVE, SUITE 932, MEMPHIS, TN 38119-4738
(901) 761-1511
Mailing address
6263 POPLAR AVE, SUITE 932, MEMPHIS, TN 38119-4738
(901) 761-1511
(901) 761-1116
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
P2077
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3982928
—
TN
01
—
4108657
BC/BS OF TN PIN
TN
Enumeration date
08/15/2006
Last updated
07/23/2007
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