Provider Demographics
NPI:1740487800
Name:MCANINCH, JULIA A (PSYD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:A
Last Name:MCANINCH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-2306
Mailing Address - Country:US
Mailing Address - Phone:615-886-8891
Mailing Address - Fax:
Practice Address - Street 1:110 21ST AVE S
Practice Address - Street 2:SUITE 1120
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2416
Practice Address - Country:US
Practice Address - Phone:615-886-8891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2761103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical