Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 2855 | TN |
NPI | 1013243484 |
---|---|
Provider Name | Dr. Paula J Fite |
First Address | Knoxville, TN 37919-5103 |
Second Address | Knoxville, TN 37919-5103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2009 |
Last Update Date | 20/10/2009 |