Individual
MS. MARY ANN EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS/CCC-SLP
Contact information
Practice address
2600 ALGOMA TER, WAUKESHA, WI 53188-4634
(262) 544-5053
Mailing address
912 N. HAWLEY, MILWAUKEE, WI 53213
(414) 615-0160
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
457-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42624400
—
WI
Enumeration date
12/05/2011
Last updated
12/05/2011
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