Individual
MR. BLAINE LAMONT EDWARDS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
936 CEDAR KNLS W, CEDAR CITY, UT 84720-3631
(435) 590-2377
Mailing address
936 CEDAR KNLS W, CEDAR CITY, UT 84720-3631
(435) 590-2377
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6173792-6004
UT
Other
Enumeration date
06/05/2022
Last updated
06/05/2022
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