Individual
LIESL J EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104
(173) 479-6018
(817) 347-9602
Mailing address
PO BOX 99213, FORT WORTH, TX 76199-0213
(682) 885-1860
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
38662
TX
Other
Enumeration date
04/22/2014
Last updated
01/03/2025
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