Provider Demographics
NPI:1013801638
Name:BEDELL, SUEANN
Entity type:Individual
Prefix:
First Name:SUEANN
Middle Name:
Last Name:BEDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 FARMCREST WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-6027
Mailing Address - Country:US
Mailing Address - Phone:202-749-2800
Mailing Address - Fax:
Practice Address - Street 1:12530 FAIRWOOD PKWY STE 102-1126
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-6356
Practice Address - Country:US
Practice Address - Phone:410-995-8388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician