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NPI Code Detail

MEDICARE: MS. LATANYA K EDWARDS

MEDICARE: MS. LATANYA K 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1609471317
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LATANYA K EDWARDS
Provider Business Mailing Address
First Line : 61 AIRPORT BLVD APT 314
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-8358
Country : US
Telephone Number : 347-499-6551
Fax Number :
Provider Business Practice Location Address
First Line : 851 COMMERCE BLVD
Second Line :
City : SCRANTON
State : PA
Zip : 18519-1759
Country : US
Telephone Number : 570-489-5561
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2020
Last Update Date : 12/01/2020

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Directions to “ MS. LATANYA K EDWARDS ” Practice Location

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