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NPI Code Detail

MEDICARE: KRISTEN EDWARDS CCC-SLP

MEDICARE: KRISTEN EDWARDS CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2202010926VA

General Provider Information

NPI Number : 1316626021
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN EDWARDS CCC-SLP
Provider Business Mailing Address
First Line : 815 MARYLAND AVE NE APT 105
Second Line :
City : WASHINGTON
State : DC
Zip : 20002-5340
Country : US
Telephone Number : 702-355-8940
Fax Number :
Provider Business Practice Location Address
First Line : 4620 CHERRY HILL RD STE 215
Second Line :
City : ARLINGTON
State : VA
Zip : 22207-3400
Country : US
Telephone Number : 703-243-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2023
Last Update Date : 07/12/2023

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Directions to “ KRISTEN EDWARDS CCC-SLP” Practice Location

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