Individual
SHELLY J EDWARDS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2100 GOSHEN RD, FORT WAYNE, IN 46808-1493
(260) 471-3500
(260) 471-4263
Mailing address
2100 GOSHEN RD, FORT WAYNE, IN 46808-1493
(260) 471-3500
(260) 471-4263
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35001533A
IN
Other
Enumeration date
06/24/2005
Last updated
07/08/2007
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