Individual
CASSANDRA STAR EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D./L.D.
Contact information
Practice address
3901 N BROADWAY AVE, ADA, OK 74820-1109
(580) 371-5183
Mailing address
3901 N BROADWAY AVE, ADA, OK 74820-1109
(580) 371-5183
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1604
OK
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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