Individual
JANIS L EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
408 ELMORE ST, PARK RIDGE, IL 60068-3437
(484) 678-3786
Mailing address
408 ELMORE ST, PARK RIDGE, IL 60068-3437
(484) 678-3786
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
149.014777
IL
101YM0800X
Mental Health Counselor
Q1-0000434
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000015367
—
DE
Enumeration date
01/03/2007
Last updated
11/03/2011
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