Provider Demographics
NPI:1154572899
Name:PEDONE, CAMILLE VIVIAN
Entity type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:VIVIAN
Last Name:PEDONE
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 1:116 LINEBERRY BLVD
Mailing Address - Street 2:BEACON BEHAVIORAL CONSULTANTS, INC.
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-5517
Mailing Address - Country:US
Mailing Address - Phone:615-310-6151
Mailing Address - Fax:615-288-4943
Practice Address - Street 1:116 LINEBERRY BLVD
Practice Address - Street 2:BEACON BEHAVIORAL CONSULTANTS, INC.
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-5517
Practice Address - Country:US
Practice Address - Phone:615-310-6151
Practice Address - Fax:615-288-4943
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2009-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst