| Dr Tedd Stephens Edd | |
|
2112 N Roan St 6th Fl Johnson City TN 37601 | |
| (423) 928-1379 | |
| Not Available |
| Full Name | Dr Tedd Stephens Edd |
|---|---|
| Speciality | Psychologist |
| Location | 2112 N Roan St, Johnson City, Tennessee |
| Authorized Official Name and Position | Tedd Stephens (OWENER) |
| Authorized Official Contact | 4239281379 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tedd Stephens Edd 2112 N Roan St 6th Fl Johnson City TN 37601 Ph: (423) 928-1379 | Dr Tedd Stephens Edd 2112 N Roan St 6th Fl Johnson City TN 37601 Ph: (423) 928-1379 |
| NPI Number | 1265500615 |
|---|---|
| Provider Enumeration Date | 12/02/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265500615 | NPI | - | NPPES |
| 3688713 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (Tennessee) | Primary |
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