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NPI Code Detail

MEDICARE: JANE ABRAHAM PH.D.

MEDICARE: JANE ABRAHAM 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
11041C0700XClinical Social WorkerLSW4095TN

General Provider Information

NPI Number : 1598961112
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE ABRAHAM PH.D.
Provider Business Mailing Address
First Line : 256 ANGELUS ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38112-5202
Country : US
Telephone Number : 901-272-1657
Fax Number : 901-726-4281
Provider Business Practice Location Address
First Line : 1384 MADISON AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-2327
Country : US
Telephone Number : 901-828-1332
Fax Number : 901-726-4281
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2007
Last Update Date : 07/08/2007

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