Individual
MR. JEFFREY A EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MDIV, CADC
Contact information
Practice address
926 15TH AVE, EAST MOLINE, IL 61244-2138
(309) 752-9740
(309) 752-9744
Mailing address
926 15TH AVE, EAST MOLINE, IL 61244-2138
(309) 752-9740
(309) 752-9744
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
A-8601-0001-A
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A-8601-0002-A
IL
Other
Enumeration date
10/09/2007
Last updated
01/24/2011
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