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General NPI Number Information
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NPI Number | 1952466468
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Entity Type | Organization
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Legal Business Name | EDELSON AND ASSOCIATES, INC.
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 7511 NEW LAGRANGE RD
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City | LOUISVILLE
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State | KY
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Zip | 40222-4859
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Country | US
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Telephone | 502-423-1151
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Fax | 502-423-1748
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Provider Business Mailing Address
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Address Line | 7511 NEW LAGRANGE RD
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City | LOUISVILLE
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State | KY
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Zip | 40222-4859
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Country | US
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Telephone | 502-423-1151
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Fax | 502-423-1748
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Authorized Official
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Title or Position | SECRETARY
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Name | STACY CLOYD
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Credential |
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Telephone | 904-605-4986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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