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Individual
LARRY EDWARDS
Active
Individual
LARRY EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
092982
NY
104100000X
Social Worker
Primary
092982
NY
1041C0700X
Clinical Social Worker
092982
NY
Other
Enumeration date
10/23/2014
Last updated
10/24/2014
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