Individual
MS. JAMESETTA EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BFA
Contact information
Practice address
5TH & ROOSEVELT, HINES, IL 60141
(707) 282-8387
(708) 202-7013
Mailing address
1204 TRYON RD, MICHIGAN CITY, IN 46360-2260
(708) 228-3601
(219) 875-3699
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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