Individual
REGINA C EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10112 GROVE CREST CT, NORTH CHESTERFIELD, VA 23236-5531
(804) 276-6713
(804) 271-4802
Mailing address
PO BOX 1086, CHESTERFIELD, VA 23832-9101
(804) 276-6713
(804) 271-4802
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/20/2017
Last updated
06/20/2017
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