Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | C-041656 | SC |
NPI | 1558324798 |
---|---|
Provider Name | Dr. Yolanda Vanessa Edwards |
First Address | Columbia, SC 29203-8003 |
Second Address | Columbia, SC 29203-8003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 08/07/2007 |