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NPI Code Detail

MEDICARE: JAMIE HEATHER EDWARDS

MEDICARE:   JAMIE HEATHER EDWARDS
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
11041C0700XClinical Social Worker2019035088MO

General Provider Information

NPI Number : 1568184893
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE HEATHER EDWARDS
Provider Business Mailing Address
First Line : 1052 CODDINGTON WAY
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63132-2902
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1052 CODDINGTON WAY
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63132-2902
Country : US
Telephone Number : 314-677-0275
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2022
Last Update Date : 09/13/2022

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Directions to “ JAMIE HEATHER EDWARDS ” Practice Location

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