Individual
MARK EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSW, LSW
Contact information
Practice address
175 PHILPOT LANE, BEAVER, WV 25813
(304) 254-9262
Mailing address
1309 E MAIN ST, PRINCETON, WV 24740-3043
(304) 487-2329
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
AP00942609
WV
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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