Organization Name: | EDWARDS PSYCHOLOGICAL SERVICES |
NPI Number: | 1447681853 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEVIN EDWARDS (OWNER) |
Mailing Address: | 14880 State Route 13 Thornville |
State: | OH US |
Postal Code: | 430768954 |
Phone Number: | 7402464963 |
Fax Number: | |
NPI Enumeration Date: | 12/11/2013 |
NPI Last Update Date: | 12/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 5679 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |