Individual
CAMILLE ANN EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 W WHITE RIVER BLVD, MUNCIE, IN 47303-5242
(765) 289-3341
Mailing address
2200 W WHITE RIVER BLVD, MUNCIE, IN 47303-5242
(765) 289-3341
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004672A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22004672A
STATE LICENSE
IN
Enumeration date
10/16/2018
Last updated
10/16/2018
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