Provider Demographics
NPI:1679973572
Name:BEDARD, CHRISTOPHER (LMFT, MMFT, MS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:BEDARD
Suffix:
Gender:M
Credentials:LMFT, MMFT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3309 UNICORN LAKE BLVD STE 161
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-0138
Mailing Address - Country:US
Mailing Address - Phone:940-378-0109
Mailing Address - Fax:
Practice Address - Street 1:3309 UNICORN LAKE BLVD STE 161
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0138
Practice Address - Country:US
Practice Address - Phone:940-378-0109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201631106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist