Provider Demographics
NPI:1295950186
Name:BEDWELL, JEFFREY SCOTT (PHD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:BEDWELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4000 CENTRAL FLORIDA BLVD
Mailing Address - Street 2:DEPARTMENT OF PSYCHOLOGY - UNIVERSITY OF CENTRAL FL
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32816-1390
Mailing Address - Country:US
Mailing Address - Phone:407-823-5858
Mailing Address - Fax:407-823-5862
Practice Address - Street 1:1345 CLAY ST
Practice Address - Street 2:WINTER PARK ANXIETY CLINIC
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5404
Practice Address - Country:US
Practice Address - Phone:407-416-0812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7264103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical