MEDICARE: CAROLYN M. LEMOND 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	P484	TN

General Provider Information

NPI Number	:	1730138819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN M. LEMOND PH.D.

Provider Business Mailing Address
First Line	:	5100 POPLAR AVE
Second Line	:	SUITE 2740
City	:	MEMPHIS
State	:	TN
Zip	:	38137-4000
Country	:	US
Telephone Number	:	901-682-7901
Fax Number	:	901-767-4255

Provider Business Practice Location Address
First Line	:	5100 POPLAR AVE
Second Line	:	SUITE 2740
City	:	MEMPHIS
State	:	TN
Zip	:	38137-4000
Country	:	US
Telephone Number	:	901-682-7901
Fax Number	:	901-767-4255

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	07/08/2007

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