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Organization
BETSY PEDERSEN PHD PC
Active
Organization
BETSY PEDERSEN PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH R PEDERSEN PHD (PRESIDENT)
(919) 923-3278
Entity
Organization
Contact information
Practice address
1502 W NC HIGHWAY 54, SUITE 603, DURHAM, NC 27707-5571
(919) 923-3278
(919) 419-3110
Mailing address
1502 W NC HIGHWAY 54, SUITE 603, DURHAM, NC 27707-5571
(919) 923-3278
(919) 419-3110
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1808
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1808
PRACTICE LICENSE -PSYCHOLOGIST
NC
01
—
2815321B
MEDICARE PTAN
NC
05
—
60008531D
—
NC
Enumeration date
02/20/2014
Last updated
02/20/2014
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