| Doctor Name: | MARK EDWARDS |
| NPI Number: | 1013007673 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 90-22P |
| Business Practice Address: | 800 Marshall St # 653 Little Rock, AR - 722023510 |
| Business Phone Number: | 5013641100 |
| Business Fax Number: | |
| Mailing Address: | 800 Marshall St # 653, LITTLE ROCK |
| State: | AR |
| Postal Code: | 722023510 |
| Phone Number: | 5013641100 |
| Fax Number: | |
| NPI Enumeration Date: | 10/13/2006 |
| NPI Last Update Date: | 07/31/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 90-22P |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |