Individual
MS. MYRA KAY EDGEWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
109 WEST WATAUGA AVENUE, JOHNSON CITY, TN 37604
(423) 979-7474
(423) 232-2789
Mailing address
1056 OLD STATE ROUTE 34, JONESBOROUGH, TN 37659-6308
(423) 753-7069
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4492
TN
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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