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General NPI Number Information
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NPI Number | 1639342884
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Entity Type | Individual
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Provider Name | DONALD E EDWARDS LADC
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Gender | Male
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 1001 W NORFOLK AVE
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City | NORFOLK
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State | NE
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Zip | 68701-5057
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Country | US
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Telephone | 402-371-5310
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Fax | 402-371-7483
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Provider Business Mailing Address
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Address Line | PO BOX 2007
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City | NORFOLK
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State | NE
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Zip | 68702-2007
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Country | US
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Telephone | 402-371-5310
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Fax | 402-371-7483
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 596
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License Number State | NE
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