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General NPI Number Information
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NPI Number | 1902554066
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Entity Type | Individual
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Provider Name | KATRINA EDMONDS LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 1800 ASHBOURNE RD VIRTUAL PRACTICE
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City | ELKINS PARK
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State | PA
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Zip | 19027
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Country | US
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Telephone | 267-766-3188
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Fax | 267-774-5105
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Provider Business Mailing Address
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Address Line | PO BOX 7169
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City | ELKINS PARK
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State | PA
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Zip | 19027-0169
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Country | US
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Telephone | 267-766-3188
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Fax | 267-774-5105
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000766
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License Number State | PA
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