Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | PE0000000649 | TN |
N | 103TS0200X | School Psychologist | TN |
NPI | 1184860181 |
---|---|
Provider Name | Dr. Joel David Effler |
First Address | Knoxville, TN 37920-3705 |
Second Address | Knoxville, TN 37920-3705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2008 |
Last Update Date | 21/12/2008 |