Individual
SCOTT ANDREW EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD HSPP
Contact information
Practice address
1216 W JEFFERSON ST, KOKOMO, IN 46901-4341
(765) 854-6010
(765) 854-6011
Mailing address
PO BOX 6181, KOKOMO, IN 46904-6181
(765) 854-6010
(765) 854-6011
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041730A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000507244
ANTHEM
IN
01
—
064306000
MAGELLAN
—
05
—
200365990
—
IN
Enumeration date
08/10/2006
Last updated
12/08/2010
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