Provider Demographics
NPI:1366290918
Name:FUTCH, BRENDA ANN (PHD, PSY)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:ANN
Last Name:FUTCH
Suffix:
Gender:F
Credentials:PHD, PSY
Other - Prefix:DR
Other - First Name:BRENDA
Other - Middle Name:ANN
Other - Last Name:FUTCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7290 GREYTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-3639
Mailing Address - Country:US
Mailing Address - Phone:901-487-3954
Mailing Address - Fax:
Practice Address - Street 1:952 DECATUR ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38107-2703
Practice Address - Country:US
Practice Address - Phone:901-487-3954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral