Individual
MARY EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MEDICAL CENTER DRIVE, MORGANTOWN, WV 26506
(304) 598-4032
(304) 598-4143
Mailing address
1 MEDICAL CENTER DRIVE, MORGANTOWN, WV 26506
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1098
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1098
STATE LICENSE
WV
05
—
3810009152
—
WV
Enumeration date
10/29/2008
Last updated
11/04/2008
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