Individual
MARY ELLEN EDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
206 VILLAGE CENTER BLVD, MILTON, DE 19968-1378
(610) 574-0833
Mailing address
206 VILLAGE CENTER BLVD, MILTON, DE 19968-1378
(610) 574-0833
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
Q1-0000931
DE
163W00000X
Registered Nurse
L1-0036355
DE
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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