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General NPI Number Information
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NPI Number | 1831362870
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Entity Type | Individual
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Provider Name | CRAIG EDWARDS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | WOMACK ARMY MEDICAL CENTER DEPARTMENT OF BEHAVIORAL HEALTH
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City | FORT BRAGG
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State | NC
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Zip | 28310
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Country | US
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Telephone | 910-907-9490
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 PARK CREST CT
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City | SAN JOSE
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State | CA
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Zip | 95118-3347
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Country | US
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Telephone | 408-628-3976
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY00003921
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License Number State | WA
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