MEDICARE: MR. BRIAN MICHAEL BEDARD M.A.

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1255325395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN MICHAEL BEDARD M.A.

Provider Business Mailing Address
First Line	:	4C BALCOM ST
Second Line	:
City	:	NASHUA
State	:	NH
Zip	:	03060-3761
Country	:	US
Telephone Number	:	603-886-7062
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 PROSPECT ST
Second Line	:
City	:	NASHUA
State	:	NH
Zip	:	03060-3921
Country	:	US
Telephone Number	:	603-889-6147
Fax Number	:

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

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	07/09/2007

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