Doctor Name: | DR. BETHANN SHOUDT |
NPI Number: | 1265423362 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | PS008614L |
Business Practice Address: | 4730a Perkiomen Ave Reading, PA - 196069521 |
Business Phone Number: | 6108981370 |
Business Fax Number: | |
Mailing Address: | 67 Long Meadow Rd, ROYERSFORD |
State: | PA |
Postal Code: | 194681853 |
Phone Number: | 6108981370 |
Fax Number: | |
NPI Enumeration Date: | 10/30/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS008614L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |