Individual
JESSICA LEE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TLMHC
Contact information
Practice address
824 FLINDT DR STE 104, STORM LAKE, IA 50588-3208
(800) 242-5101
Mailing address
824 FLINDT DR STE 104, STORM LAKE, IA 50588-3208
(800) 242-5101
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
094752
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YM0800X
—
IA
Enumeration date
09/14/2017
Last updated
11/27/2023
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