Individual
JONATHAN EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15446 N GREENWAY HAYDEN LOOP, SCOTTSDALE, AZ 85260-3078
(818) 963-1017
Mailing address
15446 N GREENWAY HAYDEN LOOP, SCOTTSDALE, AZ 85260-3078
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6754-T
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6754-T
LICENSE NUMBER
AZ
Enumeration date
09/01/2021
Last updated
09/01/2021
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