Individual
DR. PEGGY JOYCE CANTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
807 UNIVERSITY PKWY, ETSU CAMPUS, JOHNSON CITY, TN 37614-6500
(423) 439-7777
(423) 439-5695
Mailing address
4 BRIARWOOD COURT, JOHNSON CITY, TN 37604-7677
(423) 360-1697
(423) 439-4472
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
P-000000901
TN
103TC0700X
Clinical Psychologist
P-000000901
TN
103TC0700X
Clinical Psychologist
Primary
P00000901
TN
Other
Enumeration date
07/02/2007
Last updated
11/23/2010
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