Organization
GENOA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS EMILY D EDWARDS MSW (OWNER, SINGLE MEMBER)
(219) 808-0793
Entity
Organization
Contact information
Practice address
222 INDIANAPOLIS BLVD STE 207, SCHERERVILLE, IN 46375-1275
(219) 808-0793
(219) 756-0795
Mailing address
222 INDIANAPOLIS BLVD STE 207, SCHERERVILLE, IN 46375-1275
(219) 808-0793
(219) 756-0795
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
99025162A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100475220C
—
IN
05
—
200240460A
—
IN
Enumeration date
04/07/2007
Last updated
02/04/2014
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