Individual
EDNA RENEE BLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSWA
Contact information
Practice address
10130 MALLARD CREEK RD STE 300, CHARLOTTE, NC 28262-6001
(704) 944-3511
Mailing address
2763 WAYBROOK DR, DALLAS, NC 28034-9598
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P011355
NC
Other
Enumeration date
01/24/2019
Last updated
05/09/2022
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