Provider Demographics
NPI:1306162326
Name:JAIN, NEELAM (PHD)
Entity type:Individual
Prefix:DR
First Name:NEELAM
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1661 INTERNATIONAL PLACE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-1431
Mailing Address - Country:US
Mailing Address - Phone:901-410-9524
Mailing Address - Fax:901-432-2415
Practice Address - Street 1:1661 INTERNATIONAL PLACE DR STE 400
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-1431
Practice Address - Country:US
Practice Address - Phone:901-410-9524
Practice Address - Fax:901-432-2415
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002840103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical