Individual
DR. PHILIP KENNETH AXTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2763
TN
103TC2200X
Clinical Child & Adolescent Psychologist
2763
TN
103TS0200X
School Psychologist
P2763
TN
Other
Enumeration date
03/08/2007
Last updated
09/29/2025
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