Provider Demographics
NPI:1639233356
Name:MCLAREN, THOMAS RALPH (PHD,, ABPN)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:RALPH
Last Name:MCLAREN
Suffix:
Gender:M
Credentials:PHD,, ABPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 HORSE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-1235
Mailing Address - Country:US
Mailing Address - Phone:423-294-1463
Mailing Address - Fax:423-763-6028
Practice Address - Street 1:4066 HIXSON PIKE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-3110
Practice Address - Country:US
Practice Address - Phone:423-870-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001864103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical