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NPI Code Detail

MEDICARE: ADRIENNE EDWARDS

MEDICARE: ADRIENNE 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1932914413
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIENNE EDWARDS
Provider Business Mailing Address
First Line : 4266 VALLIE DR
Second Line :
City : MACON
State : GA
Zip : 31204-4741
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1231 JOSEPH E BOONE BLVD NW
Second Line :
City : ATLANTA
State : GA
Zip : 30314-2395
Country : US
Telephone Number : 404-817-9994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2025
Last Update Date : 02/12/2025

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Directions to “ ADRIENNE EDWARDS ” Practice Location

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