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Individual

TAMELA ELEASIA EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, CMHC, NCC, LPC

Contact information

Practice address
771 BADGER RD STE 205, NORTH POLE, AK 99705-5710
(907) 651-8808
Mailing address
PO BOX 55846, NORTH POLE, AK 99705-0846
(404) 454-3377

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
167128
AK
101YP2500X
Professional Counselor
167128
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
167128
PROFESSIONAL COUNSELOR
AK
Enumeration date
08/28/2019
Last updated
05/11/2022
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