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General NPI Number Information
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NPI Number | 1720261316
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Entity Type | Individual
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Provider Name | JILL STINSON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 08/23/2019
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Provider Practice Location Address
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Address Line | 166 DEROSIER DR
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City | JOHNSON CITY
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State | TN
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Zip | 37614-5200
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Country | US
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Telephone | 423-439-7777
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Fax | 423-439-7780
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Provider Business Mailing Address
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Address Line | PO BOX 699
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City | MOUNTAIN HOME
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State | TN
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Zip | 37684-0699
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Country | US
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Telephone | 423-433-6039
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2007020134
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License Number State | MO
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