Individual
JACEY LYNN EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 UNIVERSITY DR, FAIRFAX, VA 22030-4422
(423) 506-5663
Mailing address
271 MILL HAMLET RD NW, CHARLESTON, TN 37310-5181
(423) 506-5663
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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