MEDICARE: JASON HOLLAND PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	3590	TN
2	103TF0200X	Forensic Psychologist	3590	TN
3	103TA0700X	Adult Development & Aging Psychologist	3590	TN

General Provider Information

NPI Number	:	1912478108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON HOLLAND PH.D.

Provider Business Mailing Address
First Line	:	118 PUBLIC SQ
Second Line	:
City	:	GALLATIN
State	:	TN
Zip	:	37066-2803
Country	:	US
Telephone Number	:	615-442-6229
Fax Number	:	615-675-0026

Provider Business Practice Location Address
First Line	:	118 PUBLIC SQ
Second Line	:
City	:	GALLATIN
State	:	TN
Zip	:	37066-2803
Country	:	US
Telephone Number	:	615-442-6229
Fax Number	:	615-675-0026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2018
Last Update Date	:	03/12/2026

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Directions to “ JASON HOLLAND PH.D.” Practice Location

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