Provider Demographics
NPI:1326234352
Name:HALL, JEAN CAMILLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:CAMILLE
Last Name:HALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10848 PARKGATE LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-3087
Mailing Address - Country:US
Mailing Address - Phone:865-974-1914
Mailing Address - Fax:865-974-3701
Practice Address - Street 1:1618 CUMBERLAND AVENUE
Practice Address - Street 2:HENSON HALL
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-3087
Practice Address - Country:US
Practice Address - Phone:865-974-1914
Practice Address - Fax:865-974-3701
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-13051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical