Provider Demographics
NPI:1568679165
Name:PEDULLA, BARBARA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:M
Last Name:PEDULLA
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 1:43 BIRCHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-4907
Mailing Address - Country:US
Mailing Address - Phone:978-443-2481
Mailing Address - Fax:
Practice Address - Street 1:321 BOSTON POST RD
Practice Address - Street 2:3C
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-3025
Practice Address - Country:US
Practice Address - Phone:978-443-2481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1838103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW50625Medicare ID - Type Unspecified