Individual
MR. PHILLIP EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4325 CLUBHOUSE DR APT H2, ALEXANDRIA, LA 71303-3572
(318) 792-2564
Mailing address
4325 CLUBHOUSE DR APT H2, ALEXANDRIA, LA 71301
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12859
LA
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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