Individual
DIANE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
403 E FLOURNOY LUCAS RD, SHREVEPORT, LA 71115-3906
(318) 213-3500
Mailing address
PO BOX 579, SUMMIT, MS 39666-0579
(601) 276-3900
(601) 276-3939
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1254
LA
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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