Individual
DR. LANCE THOMAS LAURENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
305 WESTFIELD RD, KNOXVILLE, TN 37919-4824
(865) 584-8547
(865) 584-5932
Mailing address
12524 WILLOW COVE WAY, KNOXVILLE, TN 37934-5348
(865) 966-9834
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
P000771
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023031
BC/BS PROVIDER NUMBER
TN
01
—
226475000
MAGELLAN PROVIDER NUMBER
TN
01
—
368700
TRIAGON/MEDIGAP PROV #
TN
Enumeration date
11/01/2006
Last updated
05/28/2015
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