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General NPI Number Information
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NPI Number | 1548178932
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Entity Type | Individual
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Provider Name | MISTY DAWN EDWARDS ED.S.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 340 E JACKSON ST
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City | GATE CITY
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State | VA
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Zip | 24251-3526
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Country | US
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Telephone | 276-386-6118
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Fax | 276-386-2684
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Provider Business Mailing Address
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Address Line | 340 E JACKSON ST
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City | GATE CITY
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State | VA
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Zip | 24251-3526
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Country | US
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Telephone | 276-386-6118
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Fax | 276-386-2684
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | PGP-0714684
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License Number State | VA
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