Individual
AUTUM MARIE EDGERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
151 REGIONS WAY STE A, DESTIN, FL 32541-5106
(850) 424-5469
Mailing address
1214 SHIPLEY DR, NICEVILLE, FL 32578-3953
(910) 273-0988
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SZ10922
FL
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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