| Doctor Name: | MR. WILLIAM BRYAN EDWARDS |
| NPI Number: | 1346314762 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LADC |
| License Number: | 300682 |
| Business Practice Address: | 104 1st St Nw Dodge Center, MN - 559279195 |
| Business Phone Number: | 5073749047 |
| Business Fax Number: | 5073742977 |
| Mailing Address: | Po Box 335, 104 1st St. Nw DODGE CENTER |
| State: | MN |
| Postal Code: | 559270335 |
| Phone Number: | 5073749047 |
| Fax Number: | 5073742977 |
| NPI Enumeration Date: | 11/17/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 300682 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |