Healthcare Provider Details

I. General information

NPI: 1780812826
Provider Name (Legal Business Name): JUDY ANN EDWARDS MSW, GSW, C-SSWS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUDY ANN DUNN MSW, GSW, C-SSWS

II. Dates (important events)

Enumeration Date: 06/28/2009
Last Update Date: 06/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9880 HYACINTH AVE RM 9
BATON ROUGE LA
70810-2433
US

IV. Provider business mailing address

37123 KATHLEEN AVE
PRAIRIEVILLE LA
70769-3465
US

V. Phone/Fax

Practice location:
  • Phone: 225-761-7849
  • Fax:
Mailing address:
  • Phone: 225-313-6552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6745
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: