Provider Demographics
NPI:1578933198
Name:EMERSON, JOVANNA SIMON (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOVANNA
Middle Name:SIMON
Last Name:EMERSON
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 1:106 HARPETH VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-1119
Mailing Address - Country:US
Mailing Address - Phone:615-979-7973
Mailing Address - Fax:
Practice Address - Street 1:6544 MURRAY LN
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5515
Practice Address - Country:US
Practice Address - Phone:615-507-3171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-26
Last Update Date:2015-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3105103T00000X
TN000568878103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool