Healthcare Provider Details

I. General information

NPI: 1205774924
Provider Name (Legal Business Name): JULIA LEIGH MCHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 SCENIC DR STE 12
BLUE RIDGE GA
30513-1402
US

IV. Provider business mailing address

2800 SCENIC DR STE 12
BLUE RIDGE GA
30513-1402
US

V. Phone/Fax

Practice location:
  • Phone: 706-946-0466
  • Fax:
Mailing address:
  • Phone: 706-946-0466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-523404
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: