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Individual

DR. JANE ELIZABETH EDMONDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
215 HAWTHORNE PARK, SUITE B, ATHENS, GA 30606-2164
(706) 549-1169
(706) 227-8971
Mailing address
215 HAWTHORNE PARK, SUITE B, ATHENS, GA 30606-2164
(706) 549-1169
(706) 227-8971

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2135
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10034720
AMERIGROUP
GA
Enumeration date
11/17/2006
Last updated
07/08/2007
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