Organization
PHOENIX NEUROPSYCHOLOGY AND COUNSELING CENTER
Active
Organization
PHOENIX NEUROPSYCHOLOGY AND COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANTEL OKEWOLE PSYD (CEO)
(602) 391-0044
Entity
Organization
Contact information
Practice address
382 CARRIAGE HOUSE DR STE D, JACKSON, TN 38305-2299
(602) 391-0044
Mailing address
382 CARRIAGE HOUSE DR STE D, JACKSON, TN 38305-2299
(602) 391-0044
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
07/29/2024
Last updated
08/22/2024
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