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Individual

LAURA EVELYN EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, LPC

Contact information

Practice address
535 NE 6TH AVE, ESTACADA, OR 97023-9312
(503) 630-8550
Mailing address
PO BOX 546, GRESHAM, OR 97030-0132

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C3962
OR
101YP2500X
Professional Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500707930
OR
Enumeration date
05/24/2011
Last updated
01/09/2025
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