Healthcare Provider Details

I. General information

NPI: 1275862922
Provider Name (Legal Business Name): KENDRA PARRIS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2009
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 DANNY THOMAS PL
MEMPHIS TN
38105-3678
US

IV. Provider business mailing address

262 DANNY THOMAS PL MAIL STOP 515
MEMPHIS TN
38105-3678
US

V. Phone/Fax

Practice location:
  • Phone: 888-226-4343
  • Fax: 901-595-3842
Mailing address:
  • Phone: 901-595-3006
  • Fax: 901-595-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2909
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number2909
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: