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Individual

DR. DENNIS WAYNE EDWARDS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PHD, LMFT

Contact information

Practice address
2201 FERRY ST, HEARTLAND CLINIC, LAFAYETTE, IN 47904-3047
(765) 446-9898
(765) 446-9424
Mailing address
2201 FERRY ST, HEARTLAND CLINIC, LAFAYETTE, IN 47904-3047
(765) 446-9898
(765) 446-9424

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35001121A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
35001121A
MFT LICENSE
IN
Enumeration date
01/12/2006
Last updated
07/08/2007
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