Individual
PETER ANTHONY EDWARDS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
3001 11TH ST S, FARGO, ND 58103-6048
(701) 235-8246
Mailing address
3001 11TH ST S, FARGO, ND 58103-6048
(701) 235-8246
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
483
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EDW5312
BCBS
ND
Enumeration date
05/16/2006
Last updated
07/08/2007
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