Healthcare Provider Details

I. General information

NPI: 1902913874
Provider Name (Legal Business Name): KARIN E THOMPSON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARIN E WEST PH.D.

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 JEFFERSON AVE
MEMPHIS TN
38104-2127
US

IV. Provider business mailing address

1360 E CRESTWOOD DR
MEMPHIS TN
38119-5021
US

V. Phone/Fax

Practice location:
  • Phone: 901-523-8990
  • Fax: 901-577-7467
Mailing address:
  • Phone: 901-685-8219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number619
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: