MEDICARE: JOANNE PRINDEL CALHOUN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	19-220	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30136	OTHER	MS	NATIONAL REGISTER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013069285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE PRINDEL CALHOUN PH.D.

Provider Business Mailing Address
First Line	:	2472 PASS RD
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39531-2838
Country	:	US
Telephone Number	:	228-388-9303
Fax Number	:	228-388-9306

Provider Business Practice Location Address
First Line	:	904 DESOTO ST
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3737
Country	:	US
Telephone Number	:	228-872-8429
Fax Number	:	228-872-0226

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	07/09/2007

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