Individual
KATIE DANIELLE EDMONDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1190 PARKER SQ, FLOWER MOUND, TX 75028-7432
(972) 316-9593
Mailing address
2456 FORT WORTH AVE APT 7304, DALLAS, TX 75211-1829
(972) 533-3488
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
79959
TX
Other
Enumeration date
11/19/2018
Last updated
11/19/2018
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