Healthcare Provider Details
I. General information
NPI: 1891612446
Provider Name (Legal Business Name): THERESA EDMUNDS CHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5625 STRAND BLVD STE 508
NAPLES FL
34110-7384
US
IV. Provider business mailing address
4251 RAFFIA PALM CIR
NAPLES FL
34119-9678
US
V. Phone/Fax
- Phone: 239-778-6842
- Fax:
- Phone: 239-778-6842
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: