Healthcare Provider Details

I. General information

NPI: 1386065944
Provider Name (Legal Business Name): ANGELLA KOCIAN PSY.D., LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2013
Last Update Date: 09/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 DIVISION ST
NASHVILLE TN
37203-4000
US

IV. Provider business mailing address

1200 DIVISION ST
NASHVILLE TN
37203-4000
US

V. Phone/Fax

Practice location:
  • Phone: 615-274-8400
  • Fax:
Mailing address:
  • Phone: 615-274-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number5670
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3311
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: