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NPI Code Detail

MEDICARE: MS. DEBORAH L EDMOND

MEDICARE:  MS. DEBORAH L EDMOND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1134200835
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBORAH L EDMOND
Provider Business Mailing Address
First Line : 1662 S ORANGE GROVE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90019-4933
Country : US
Telephone Number : 310-668-5151
Fax Number : 310-223-0695
Provider Business Practice Location Address
First Line : 1662 S ORANGE GROVE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90019-4933
Country : US
Telephone Number : 310-668-5151
Fax Number : 310-223-0695
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 07/08/2007

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Directions to “ MS. DEBORAH L EDMOND ” Practice Location

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