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Individual

MR. JOHN KENNEDY EDMOND SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1036 BRANCHVIEW DR, SUITE 201, CONCORD, NC 28025-2998
(704) 793-9593
(704) 795-0825
Mailing address
1036 BRANCHVIEW DR, SUITE 201, CONCORD, NC 28025-2998
(704) 793-9593
(704) 795-0825

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6603176
NC
05
6603333
NC
05
6603560
NC
Enumeration date
01/08/2007
Last updated
07/09/2007
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