Provider Demographics
NPI:1336296771
Name:HANAUER, ALLISON CLIFFORD (PHD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:CLIFFORD
Last Name:HANAUER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:CLIFFORD
Other - Last Name:JEFFREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1211 UNION AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6655
Mailing Address - Country:US
Mailing Address - Phone:901-478-0954
Mailing Address - Fax:901-478-0951
Practice Address - Street 1:3950 NEW COVINGTON PIKE STE 110
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2595
Practice Address - Country:US
Practice Address - Phone:901-387-2900
Practice Address - Fax:901-384-1645
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1180103TC0700X
TN2676103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4120824OtherBLUE CROSS BLUE SHIELD