Laurie Edwards Phd Pllc | |
430 Alta Vista St Ste 5 Santa Fe NM 87505-4140 | |
(808) 772-0423 | |
(866) 821-5133 |
Full Name | Laurie Edwards Phd Pllc |
---|---|
Speciality | Psychologist |
Location | 430 Alta Vista St Ste 5, Santa Fe, New Mexico |
Authorized Official Name and Position | Laurie Edwards (OWNER) |
Authorized Official Contact | 8087720423 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Laurie Edwards Phd Pllc 903 W Alameda St Santa Fe NM 87501-1681 Ph: (808) 772-0423 | Laurie Edwards Phd Pllc 430 Alta Vista St Ste 5 Santa Fe NM 87505-4140 Ph: (808) 772-0423 |
NPI Number | 1427359314 |
---|---|
Provider Enumeration Date | 11/08/2010 |
Last Update Date | 01/17/2024 |
Certification Date | 12/11/2023 |
Medicare PECOS PAC ID | 5395932164 |
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Medicare Enrollment ID | O20101206000575 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427359314 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | PSY 1108 (Hawaii) | Primary |
Provider Name | Laurie A Edwards |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1396942611 PECOS PAC ID: 9638366412 Enrollment ID: I20101206000680 |
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