Provider Demographics
NPI:1396998613
Name:KNOXVILLE PSYCHOLOGICAL CENTER, PLLC
Entity type:Organization
Organization Name:KNOXVILLE PSYCHOLOGICAL CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:BRANCA
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:865-450-9880
Mailing Address - Street 1:4048 SUTHERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5103
Mailing Address - Country:US
Mailing Address - Phone:865-450-9880
Mailing Address - Fax:
Practice Address - Street 1:4048 SUTHERLAND AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5103
Practice Address - Country:US
Practice Address - Phone:865-450-9880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2662103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty