Provider Demographics
NPI:1154552354
Name:PEDIGO WILKINSON, NANCY P (LMFT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:P
Last Name:PEDIGO WILKINSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:LAVERGNE
Other - Last Name:PEDIGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 CENTER POINTE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-1632
Mailing Address - Country:US
Mailing Address - Phone:931-648-4897
Mailing Address - Fax:931-906-9735
Practice Address - Street 1:120 CENTER POINTE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-1632
Practice Address - Country:US
Practice Address - Phone:931-648-4897
Practice Address - Fax:931-906-9735
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN674106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist