| Peter A. Beddow, Phd, Llc | |
|
100 Brian Cir Antioch TN 37013-4340 | |
| (615) 403-8206 | |
| (615) 301-6196 |
| Full Name | Peter A. Beddow, Phd, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 100 Brian Cir, Antioch, Tennessee |
| Authorized Official Name and Position | Peter A. Beddow (PRESIDENT/OWNER) |
| Authorized Official Contact | 6154038206 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter A. Beddow, Phd, Llc 100 Brian Cir Antioch TN 37013-4340 Ph: (615) 403-8206 | Peter A. Beddow, Phd, Llc 100 Brian Cir Antioch TN 37013-4340 Ph: (615) 403-8206 |
| NPI Number | 1811320435 |
|---|---|
| Provider Enumeration Date | 08/19/2013 |
| Last Update Date | 10/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811320435 | NPI | - | NPPES |
| 1524627 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-12-11796 (Colorado) | Primary |
| 235Z00000X | Speech-language Pathologist | 5228 (Tennessee) | Secondary |
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