Individual
DR. LAWRENCE CHRISTIAN ELLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
UNIVERSITY OF TENNESSEE, 1404 CIRCLE DRIVE, AUSTIN PEAY, 301F, KNOXVILLE, TN 37996-4503
(865) 974-1958
Mailing address
UNIVERSITY OF TENNESSEE, 1404 CIRCLE DRIVE, AUSTIN PEAY, 301F, KNOXVILLE, TN 37996-4503
(865) 974-1958
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
T-LP1978
KS
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
T-LP1978
KS
Other
Enumeration date
04/25/2012
Last updated
12/06/2013
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