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General NPI Number Information
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NPI Number | 1720388150
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Entity Type | Individual
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Provider Name | TINA MARIE BEDELL LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 4 BRADLEY PARK CT STE 1H
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City | COLUMBUS
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State | GA
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Zip | 31904-3634
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Country | US
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Telephone | 706-327-1222
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Fax | 706-327-1444
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Provider Business Mailing Address
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Address Line | 4 BRADLEY PARK CT STE 1H
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City | COLUMBUS
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State | GA
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Zip | 31904-3634
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Country | US
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Telephone | 706-327-1222
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Fax | 706-327-1444
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT001174
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License Number State | GA
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