MEDICARE: MS. JOYCE M. EDWARDS MSW

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
1	104100000X	Social Worker	6249	LA

General Provider Information

NPI Number	:	1588787956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOYCE M. EDWARDS MSW

Provider Business Mailing Address
First Line	:	1380 RIVER BEND DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-4914
Country	:	US
Telephone Number	:	214-743-1200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1380 RIVER BEND AVE.
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-4929
Country	:	US
Telephone Number	:	972-227-7301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	07/08/2007

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