Individual
KEVIN J EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
12 B WEST COLUMBUS ST, THORNVILLE, OH 43076-0602
(740) 246-4963
Mailing address
PO BOX 602, THORNVILLE, OH 43076-0602
(740) 246-4963
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5679
OH
Other
Enumeration date
06/13/2006
Last updated
03/02/2009
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