Provider Demographics
NPI:1194842310
Name:EDGINGTON, BETTY MARTIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BETTY
Middle Name:MARTIN
Last Name:EDGINGTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 GLEN MOORE CIR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4055
Mailing Address - Country:US
Mailing Address - Phone:717-947-4750
Mailing Address - Fax:717-910-4544
Practice Address - Street 1:73 GLEN MOORE CIR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4055
Practice Address - Country:US
Practice Address - Phone:717-947-4750
Practice Address - Fax:717-910-4544
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA017521103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty