Healthcare Provider Details

I. General information

NPI: 1932621075
Provider Name (Legal Business Name): ASHLEY MARIA EDWARDS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2421 13TH ST NW
CANTON OH
44708-3116
US

IV. Provider business mailing address

2421 13TH ST NW
CANTON OH
44708-3116
US

V. Phone/Fax

Practice location:
  • Phone: 330-452-6000
  • Fax: 330-452-3875
Mailing address:
  • Phone: 330-452-6000
  • Fax: 330-452-3875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberS.1700044
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: