| Doctor Name: | MR. JOHN O EDWARDS |
| NPI Number: | 1023131372 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LEAP |
| License Number: | 00007 |
| Business Practice Address: | 205 Powell Pl Brentwood, TN - 370277522 |
| Business Phone Number: | 6153690879 |
| Business Fax Number: | |
| Mailing Address: | 205 Powell Pl, BRENTWOOD |
| State: | TN |
| Postal Code: | 370277522 |
| Phone Number: | 6153690879 |
| Fax Number: | |
| NPI Enumeration Date: | 04/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 00007 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |