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Individual
EDWARD EDGAR
Active
Individual
EDWARD EDGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.A.D.C.
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000374
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300000374CT01
ANTHEM BLUE CROSS
CT
01
—
300000374CT02
ANTHEM BLUE CROSS
CT
Enumeration date
05/17/2007
Last updated
01/27/2012
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