Individual
LAURIE BEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 MAHANTONGO ST, POTTSVILLE, PA 17901-3010
(570) 622-6417
Mailing address
1236 SCHUYLKILL MOUNTAIN RD, SCHUYLKILL HAVEN, PA 17972-9152
(570) 527-7907
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH000798
PA
Other
Enumeration date
04/22/2015
Last updated
04/22/2015
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