Individual
PAMELA MAXINE DETRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2000 N PARKWAY, MEMPHIS, TN 38112-1624
(901) 843-3128
Mailing address
430 N WILLETT ST, MEMPHIS, TN 38112-5122
(901) 278-7198
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
P0000002491
TN
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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