Individual
DR. ALICIA LUSCOMB AUTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7516 ENTERPRISE AVE, SUITE 1, GERMANTOWN, TN 38138-3802
(901) 755-5802
(901) 757-2249
Mailing address
7516 ENTERPRISE AVE, SUITE 1, GERMANTOWN, TN 38138-3802
(901) 755-5802
(901) 757-2249
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PROVISIONAL 3440
TN
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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