Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC007770 | PA |
NPI | 1003356908 |
---|---|
Provider Name | Mrs. Lindsay Meeks Edwards |
First Address | Philadelphia, PA 19123-1957 |
Second Address | Philadelphia, PA 19123-1957 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2017 |
Last Update Date | 27/02/2017 |