| 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 |
|---|---|
| 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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