Organization
KHANEDRA Z EDWARDS
Active
Other names
Simply Speaking
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KHANEDRA EDWARDS BRYANT MS,CCC-SLP (SPEECH PATHOLOGIST)
(219) 331-9514
Entity
Organization
Contact information
Practice address
760 N RANDOLPH ST, GARY, IN 46403-2257
(219) 331-9514
(219) 939-0020
Mailing address
PO BOX 812, PORTAGE, IN 46368-0812
(219) 331-9514
(219) 939-0020
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003661A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200673060
—
IN
05
—
200726320
—
IN
Enumeration date
02/10/2007
Last updated
07/02/2008
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