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General NPI Number Information
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NPI Number | 1780057810
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Entity Type | Individual
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Provider Name | TIMIKA S EDWARDS PHD
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Gender | Female
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 7110 OAKLAND AVE STE 105
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1870
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Country | US
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Telephone | 314-270-2343
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Fax | 314-925-9727
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Provider Business Mailing Address
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Address Line | PO BOX 430175
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City | SAINT LOUIS
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State | MO
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Zip | 63143-0275
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Country | US
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Telephone | 314-270-2343
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Fax | 314-925-9727
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 2014040973
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2014040973
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License Number State | MO
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