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General NPI Number Information
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NPI Number | 1861556482
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Entity Type | Individual
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Provider Name | BENJAMIN JAMES BILLER M.S. S.P.E.
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 01/04/2010
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Provider Practice Location Address
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Address Line | 2292 CHAMBLISS AVE NW SUITE C-2
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City | CLEVELAND
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State | TN
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Zip | 37311-3862
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Country | US
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Telephone | 423-479-5672
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Fax | 423-479-5679
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Provider Business Mailing Address
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Address Line | PO BOX 2965
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City | CLEVELAND
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State | TN
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Zip | 37320-2965
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Country | US
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Telephone | 423-479-5672
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Fax | 423-479-5679
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PE0000011766
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License Number State | TN
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