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General NPI Number Information
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NPI Number | 1467569467
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Entity Type | Individual
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Provider Name | KATHLEEN ANN EDWARDS M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | SCOTTISH RITE CHILDHOOD LANGUAGE CENTER 4202 HERMITAGE ROAD
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City | RICHMOND
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State | VA
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Zip | 23227-3755
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Country | US
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Telephone | 804-266-6699
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Fax | 804-264-5988
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Provider Business Mailing Address
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Address Line | 4202 HERMITAGE ROAD
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City | RICHMOND
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State | VA
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Zip | 23227-3755
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Country | US
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Telephone | 804-266-6699
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Fax | 804-264-5988
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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 | 2202001611
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License Number State | VA
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