Individual
ELIZABETH MARY EDLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NLC, MA
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20171447254
TRADE NAME
—
Enumeration date
06/15/2017
Last updated
07/21/2022
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