Healthcare Provider Details

I. General information

NPI: 1215136544
Provider Name (Legal Business Name): KATIE F. CAMENZIND PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATIE LAUREN FITZPATRICK PH.D.

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 05/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 WESTFIELD DR
KNOXVILLE TN
37919
US

IV. Provider business mailing address

209 DREAM VIEW DR
MILLS RIVER NC
28759-7671
US

V. Phone/Fax

Practice location:
  • Phone: 865-264-2400
  • Fax: 865-588-6406
Mailing address:
  • Phone: 865-386-8329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: