Provider Demographics
NPI:1184859209
Name:MCCANE-BOWLING, SARA JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:JEAN
Last Name:MCCANE-BOWLING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:JEAN
Other - Last Name:MCCANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:10321 RED WATER LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-1580
Mailing Address - Country:US
Mailing Address - Phone:865-769-3088
Mailing Address - Fax:
Practice Address - Street 1:10321 RED WATER LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-1580
Practice Address - Country:US
Practice Address - Phone:865-769-3088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2806103TH0100X
103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool