Healthcare Provider Details

I. General information

NPI: 1588595276
Provider Name (Legal Business Name): ANJAIL NEWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

969 FRAYSER BLVD
MEMPHIS TN
38127-5977
US

IV. Provider business mailing address

2941 190TH PL
LANSING IL
60438-3475
US

V. Phone/Fax

Practice location:
  • Phone: 901-842-3162
  • Fax:
Mailing address:
  • Phone: 708-548-5242
  • 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: