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Individual

CONNIE S PAUL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
5154 STAGE RD, SUITE 102, MEMPHIS, TN 38134-3118
(901) 372-9133
(901) 372-1015
Mailing address
5154 STAGE RD, SUITE 102, MEMPHIS, TN 38134-3118
(901) 372-9133
(901) 372-1015

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
P772
TN
103TC0700X
Clinical Psychologist
P772
TN
103TH0100X
Health Service Psychologist
Primary
P772
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2134263
CIGNA BEHAVIORAL HEALTH
05
3682508
TN
01
4053320
BCBS OF TN MENTAL HEALTH
TN
01
4067036
BCBS OF TN MEDICAL
TN
Enumeration date
06/25/2006
Last updated
09/11/2025
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