MEDICARE: DR. CATHERINE ANN LAWHEAD PHD

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	103T00000X	Psychologist	P1917	TN

General Provider Information

NPI Number	:	1255435418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE ANN LAWHEAD PHD

Provider Business Mailing Address
First Line	:	PO BOX 381344
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38183-1344
Country	:	US
Telephone Number	:	901-496-8149
Fax Number	:	901-414-1711

Provider Business Practice Location Address
First Line	:	4646 POPLAR AVE
Second Line	:	#326
City	:	MEMPHIS
State	:	TN
Zip	:	38117-4426
Country	:	US
Telephone Number	:	901-496-8149
Fax Number	:	901-414-1711

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

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	05/20/2013

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