Healthcare Provider Details

I. General information

NPI: 1336296771
Provider Name (Legal Business Name): ALLISON CLIFFORD HANAUER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON CLIFFORD JEFFREY PH.D.

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 NEW COVINGTON PIKE STE 110
MEMPHIS TN
38128-2595
US

IV. Provider business mailing address

1211 UNION AVE STE 330
MEMPHIS TN
38104-6655
US

V. Phone/Fax

Practice location:
  • Phone: 901-387-2900
  • Fax: 901-384-1645
Mailing address:
  • Phone: 901-478-0954
  • Fax: 901-478-0951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1180
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2676
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: