Individual
MARIAH EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5601 33RD AVE S APT 310, FARGO, ND 58104-0006
(816) 288-0222
Mailing address
920 S NATIONAL AVE APT 101, SPRINGFIELD, MO 65804-2244
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
995-24
ND
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/09/2021
Last updated
07/17/2024
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