Provider Demographics
NPI:1568583839
Name:CHAPMAN, JEANE PERKINS (EDS)
Entity Type:Individual
Prefix:
First Name:JEANE
Middle Name:PERKINS
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3762 MASONWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-4012
Mailing Address - Country:US
Mailing Address - Phone:901-345-1476
Mailing Address - Fax:901-205-8090
Practice Address - Street 1:3762 MASONWOOD LN
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-4012
Practice Address - Country:US
Practice Address - Phone:901-345-1476
Practice Address - Fax:901-205-8090
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPE0000000264103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool