Provider Demographics
NPI:1508840372
Name:BERRYMAN, JANIE L (EDD)
Entity Type:Individual
Prefix:DR
First Name:JANIE
Middle Name:L
Last Name:BERRYMAN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 507
Mailing Address - Street 2:
Mailing Address - City:KINGSTON SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37082-0507
Mailing Address - Country:US
Mailing Address - Phone:615-662-7979
Mailing Address - Fax:615-662-7974
Practice Address - Street 1:173 BELLE FOREST CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2103
Practice Address - Country:US
Practice Address - Phone:615-662-7979
Practice Address - Fax:615-662-7974
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002095103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist