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General NPI Number Information
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NPI Number | 1699390302
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Entity Type | Individual
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Provider Name | TRENA LEIGH EDWARDS LPC-S
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Gender | Female
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 3616 YOUREE DR
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City | SHREVEPORT
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State | LA
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Zip | 71105-2122
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Country | US
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Telephone | 318-779-0104
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Fax | 318-421-3193
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Provider Business Mailing Address
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Address Line | 10010 WILLOWWICK CT
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City | SHREVEPORT
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State | LA
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Zip | 71118-4521
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Country | US
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Telephone | 318-935-9585
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Fax | 318-421-3193
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7315
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License Number State | LA
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