Individual
BEVERLY JOANNE CLONTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
223 MINERAL ST, NEWPORT, TN 37821-3827
(423) 608-4700
Mailing address
223 MINERAL ST, NEWPORT, TN 37821-3827
(423) 608-4700
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P1668
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3686403
—
TN
Enumeration date
07/12/2005
Last updated
11/20/2023
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