Provider Demographics
NPI:1669649463
Name:JAMERSON, JANETTA (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANETTA
Middle Name:
Last Name:JAMERSON
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 1:923 ASHBROOKE WAY
Mailing Address - Street 2:APT. 921
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-6389
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:923 ASHBROOKE WAY
Practice Address - Street 2:APT. 921
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-6389
Practice Address - Country:US
Practice Address - Phone:865-769-8152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2775103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical