Provider Demographics
NPI:1730205410
Name:PANTER, JANET EWING (PSYCHOLOGIST/HSP)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:EWING
Last Name:PANTER
Suffix:
Gender:F
Credentials:PSYCHOLOGIST/HSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5154 STAGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3118
Mailing Address - Country:US
Mailing Address - Phone:901-372-9133
Mailing Address - Fax:901-372-1015
Practice Address - Street 1:5154 STAGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-3118
Practice Address - Country:US
Practice Address - Phone:901-372-9133
Practice Address - Fax:901-372-1015
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2309103TH0100X
TNP-2309103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool