Healthcare Provider Details

I. General information

NPI: 1265359301
Provider Name (Legal Business Name): JULIA BROOKE CLABORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 INDUSTRIAL LN
ONEIDA TN
37841-6294
US

IV. Provider business mailing address

161 EMILY LN
ONEIDA TN
37841-5977
US

V. Phone/Fax

Practice location:
  • Phone: 423-286-0807
  • Fax: 423-289-9721
Mailing address:
  • Phone: 423-286-0807
  • Fax: 423-289-9721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: