Provider Demographics
NPI:1073695870
Name:MCCLENAGHAN BAILEY, J. JOLENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:J.
Middle Name:JOLENE
Last Name:MCCLENAGHAN BAILEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 EXETER RD
Mailing Address - Street 2:SYUTE 1
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3945
Mailing Address - Country:US
Mailing Address - Phone:901-218-1835
Mailing Address - Fax:901-755-6152
Practice Address - Street 1:2022 EXETER RD
Practice Address - Street 2:SUITE 1
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3945
Practice Address - Country:US
Practice Address - Phone:901-218-1835
Practice Address - Fax:901-755-6152
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2459103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist