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General NPI Number Information
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NPI Number | 1245642388
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Entity Type | Individual
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Provider Name | MYREI CHRYSTI EDWARDS LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/23/2014
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Last Update Date | 05/23/2014
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Provider Practice Location Address
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Address Line | 4500 MONTROSE BLVD STE E
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City | HOUSTON
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State | TX
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Zip | 77006-5842
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Country | US
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Telephone | 832-244-7428
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Fax |
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Provider Business Mailing Address
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Address Line | 14922 EL TESORO DR
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City | HOUSTON
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State | TX
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Zip | 77083-2520
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Country | US
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Telephone | 832-244-7428
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 32093
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License Number State | TX
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