Individual
MRS. ROBERTA W EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEECH PATHOLOGIST
Contact information
Practice address
4607 LINDBERGH DR, JACKSON, MS 39209-3855
(601) 203-6378
(601) 203-6379
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 813-5460
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2373
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07071013
—
MS
Enumeration date
03/23/2007
Last updated
01/06/2022
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