Individual
MR. MICHAEL J EDWARDS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MINISTER
Contact information
Practice address
2102 TRADEWIND DR, SUITE 172, MESQUITE, TX 75150-3309
(601) 810-5788
Mailing address
1017 HANEY RD STE C, SUMMIT, MS 39666-9079
(601) 810-5788
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
171100000X
Acupuncturist
—
—
171R00000X
Interpreter
—
—
172A00000X
Driver
—
—
172V00000X
Community Health Worker
—
—
225700000X
Massage Therapist
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
07/14/2009
Last updated
01/20/2012
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