Provider Demographics
NPI:1992850408
Name:BERRY-SAWYER, KIMBERLEE CAROLINE (PHD)
Entity Type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:CAROLINE
Last Name:BERRY-SAWYER
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:PO BOX 4362
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-0362
Mailing Address - Country:US
Mailing Address - Phone:423-243-6039
Mailing Address - Fax:
Practice Address - Street 1:3209 OZARK CIR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-5107
Practice Address - Country:US
Practice Address - Phone:423-243-6039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002607103TC0700X
TN2607103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical