Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician |
NPI | 1003349267 |
---|---|
Provider Name | Chelsea Edwards |
First Address | St George, UT 84770-7156 |
Second Address | St George, UT 84770-7156 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2017 |
Last Update Date | 05/04/2017 |