Most Relevant Information
Provider Data
| NPI Number: | 1003637851 |
| Provider Name: | KATHERINE ELLIS LIGHT PHD |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC1900X |
| Specialty: | Psychologist |
| License Number: | 4109 |
Most Important Dates
| Enumeration Date: | 10/23/2024 |
| Last Updated: | 10/23/2024 |
Provider Practice Location
1319 OLD WEISGARBER RD
KNOXVILLE
TN
379091284
Practice Location Phone/Fax
| Phone: | 8652176853 |
| Fax: |
Provider Mailing Location
515 MORRELL RD APT G100
KNOXVILLE
TN
379195868
Provider Mailing Phone/Fax
| Phone: | 6606192364 |
| Fax: |