Provider Demographics
NPI:1174561054
Name:PARRISH, J KIP (PHD)
Entity type:Individual
Prefix:
First Name:J
Middle Name:KIP
Last Name:PARRISH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 POPLAR AVE
Mailing Address - Street 2:SUITE 2700
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38137-4000
Mailing Address - Country:US
Mailing Address - Phone:901-682-4199
Mailing Address - Fax:901-850-9793
Practice Address - Street 1:5100 POPLAR AVE
Practice Address - Street 2:SUITE 2700
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38137-4000
Practice Address - Country:US
Practice Address - Phone:901-682-4199
Practice Address - Fax:901-850-9793
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000000833103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical