Provider Demographics
NPI:1386065944
Name:KOCIAN, ANGELLA (PSYD, LP)
Entity type:Individual
Prefix:DR
First Name:ANGELLA
Middle Name:
Last Name:KOCIAN
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-4000
Mailing Address - Country:US
Mailing Address - Phone:615-274-8400
Mailing Address - Fax:
Practice Address - Street 1:1200 DIVISION ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-4000
Practice Address - Country:US
Practice Address - Phone:615-274-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-30
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5670103TC1900X
TN3311103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling