Provider Demographics
NPI:1689750788
Name:KAUFMAN, HARVEY PETER (EDD)
Entity Type:Individual
Prefix:MISS
First Name:HARVEY
Middle Name:PETER
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10909 LOOKOUT PT
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-4076
Mailing Address - Country:US
Mailing Address - Phone:865-966-1956
Mailing Address - Fax:
Practice Address - Street 1:2 FOREST CT
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5001
Practice Address - Country:US
Practice Address - Phone:865-588-1868
Practice Address - Fax:865-558-6260
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN364POOOOO103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service