Individual
ANGEL EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
136 NORTH 28TH STREET, GATESVILLE, TX 76528
(719) 217-1030
Mailing address
136 NORTH 28TH STREET, GATESVILLE, TX 76528
(719) 217-1030
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
16-25740
GA
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
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