Individual
KEVIN EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
712 AVENIDA CASTELLANO, SANTA FE, NM 87501-8902
(301) 351-6513
Mailing address
712 AVENIDA CASTELLANO, SANTA FE, NM 87501-8902
(301) 351-6513
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
Primary
OT-2024-0049
NM
Other
Enumeration date
06/01/2020
Last updated
01/29/2025
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