Individual
JUDITH G CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5594 TYLERTOWN AVE, BARTLETT, TN 38134-3356
(901) 382-8411
Mailing address
5594 TYLERTOWN AVE, BARTLETT, TN 38134-3356
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P0000000991
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3681389
—
TN
01
—
680016204
RR MEDICARE # - PARADIGM
TN
Enumeration date
09/28/2006
Last updated
11/30/2015
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