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General NPI Number Information
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NPI Number | 1316448475
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Entity Type | Individual
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Provider Name | DEBRA ANN KLINE EDWARDS
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Gender | Female
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 02/23/2018
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Provider Practice Location Address
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Address Line | 2025 KEMPSVILLE RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6805
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Country | US
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Telephone | 757-648-3840
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Fax |
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Provider Business Mailing Address
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Address Line | 464 W PLANTATION RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-4032
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Country | US
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Telephone | 757-651-0203
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202002073
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License Number State | VA
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