Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003336918 |
---|---|
Provider Name | Erolyn Edwards |
First Address | Hammond, LA 70401-3316 |
Second Address | Hammond, LA 70401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2017 |
Last Update Date | 21/06/2017 |