Individual
CONNIE JOY DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDD
Contact information
Practice address
6110 SHALLOWFORD RD, C O CRC FOR PARADIGM, CHATTANOOGA, TN 37421-1894
(800) 632-6074
(866) 341-7509
Mailing address
3205 VERA VALLEY RD, FRANKLIN, TN 37064
(615) 591-6507
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P0000002092
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3981313
—
TN
01
—
4090359
BCBS
TN
01
—
P00242852
RAILROAD MEDICARE
TN
Enumeration date
09/19/2006
Last updated
02/13/2008
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