Provider Demographics
NPI:1275363939
Name:EDMONDS, LYDIA
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:EDMONDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 BRENTWOOD PL APT 1204
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-6277
Mailing Address - Country:US
Mailing Address - Phone:901-687-0949
Mailing Address - Fax:
Practice Address - Street 1:3343 ASPEN GROVE DR STE 240
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2921
Practice Address - Country:US
Practice Address - Phone:615-651-4833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist