Provider Demographics
NPI:1801212741
Name:GREENEVILLE EVALUATION SERVICE
Entity type:Organization
Organization Name:GREENEVILLE EVALUATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PSYCHOLOGICAL EXAMINER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:LSPE
Authorized Official - Phone:423-747-9254
Mailing Address - Street 1:PO BOX 242
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:TN
Mailing Address - Zip Code:37616-0242
Mailing Address - Country:US
Mailing Address - Phone:423-747-9254
Mailing Address - Fax:423-388-4180
Practice Address - Street 1:816 TUSCULUM BLVD STE 3
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4092
Practice Address - Country:US
Practice Address - Phone:423-747-9254
Practice Address - Fax:423-388-4180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11758103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty