Individual
LAURA JEAN EDMONDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, LCDC
Contact information
Practice address
1075 KINWEST PKWY STE 107, IRVING, TX 75063-3411
(972) 910-8388
Mailing address
1075 KINWEST PKWY STE 107, IRVING, TX 75063-3411
(972) 910-8388
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
69795
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
12184
TX
101YM0800X
Mental Health Counselor
69795
TX
Other
Enumeration date
06/20/2016
Last updated
01/08/2019
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