Organization
DR TEDD STEPHENS EDD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TEDD STEPHENS EDD (OWENER)
(423) 928-1379
Entity
Organization
Contact information
Practice address
2112 N ROAN ST, 6TH FL, JOHNSON CITY, TN 37601
(423) 928-1379
Mailing address
2112 N ROAN ST, 6TH FL, JOHNSON CITY, TN 37601
(423) 928-1379
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3688713
—
TN
Enumeration date
12/02/2006
Last updated
08/22/2020
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