Provider Demographics
NPI:1942640982
Name:SCHALLER, JANET (PHD, MDIV)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:SCHALLER
Suffix:
Gender:F
Credentials:PHD, MDIV
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:RICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35 S AUBURNDALE ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3916
Mailing Address - Country:US
Mailing Address - Phone:901-729-3900
Mailing Address - Fax:901-729-2737
Practice Address - Street 1:35 S AUBURNDALE ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3916
Practice Address - Country:US
Practice Address - Phone:901-729-3900
Practice Address - Fax:901-729-2737
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN56101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral