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Individual

LAURA STOCKDALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
305 WESTFIELD DR, KNOXVILLE, TN 37919-4824
(865) 264-2400
Mailing address
6231 HIGHLAND PLACE WAY, STE 101, KNOXVILLE, TN 37919-4083
(865) 264-2400
(865) 588-6406

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P0000001492
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3980093
TN
01
4076563
BCBS
TN
01
P00106939
RAILROAD MEDICARE
TN
Enumeration date
09/19/2006
Last updated
09/16/2019
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