Provider Demographics
NPI:1013023605
Name:CAVANAUGH, JANNA ODDIE (PSY D)
Entity Type:Individual
Prefix:DR
First Name:JANNA
Middle Name:ODDIE
Last Name:CAVANAUGH
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:DR
Other - First Name:JANNA
Other - Middle Name:LEIGH
Other - Last Name:ODDIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:305 N HEATHERWILDE BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-4195
Mailing Address - Country:US
Mailing Address - Phone:512-704-8349
Mailing Address - Fax:
Practice Address - Street 1:305 N HEATHERWILDE BLVD
Practice Address - Street 2:STE 310
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-4195
Practice Address - Country:US
Practice Address - Phone:512-787-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18378103T00000X
TX33590103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist