MEDICARE: DR. DEBORAH ENNIS DOINEAU ED.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TP0016X	Prescribing (Medical) Psychologist	P-1712	TN

General Provider Information

NPI Number	:	1902026974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH ENNIS DOINEAU ED.D.

Provider Business Mailing Address
First Line	:	2900 BELMONT BLVD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-5908
Country	:	US
Telephone Number	:	615-383-8654
Fax Number	:	615-292-1136

Provider Business Practice Location Address
First Line	:	2120 CRESTMOOR RD STE 3011
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2613
Country	:	US
Telephone Number	:	615-297-1816
Fax Number	:	615-292-1136

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/08/2007

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