| Doctor Name: | THOMAS WILLIAM PEDERSEN |
| NPI Number: | 1326145806 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | PSY002564 |
| Business Practice Address: | 561 Kailors Cove Cir Ringgold, GA - 307363372 |
| Business Phone Number: | 4235808896 |
| Business Fax Number: | |
| Mailing Address: | 561 Kailors Cove Cir, RINGGOLD |
| State: | GA |
| Postal Code: | 307363372 |
| Phone Number: | 4235808896 |
| Fax Number: | |
| NPI Enumeration Date: | 09/19/2006 |
| NPI Last Update Date: | 03/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY002564 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |