Provider Demographics
NPI:1386718120
Name:EDWARDS, BARBARA LOUISE (MA)
Entity type:Individual
Prefix:MISS
First Name:BARBARA
Middle Name:LOUISE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 STATE ST
Mailing Address - Street 2:SUITE 724
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1814
Mailing Address - Country:US
Mailing Address - Phone:814-480-5751
Mailing Address - Fax:
Practice Address - Street 1:1001 STATE ST
Practice Address - Street 2:SUITE 724
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1814
Practice Address - Country:US
Practice Address - Phone:814-480-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005769L103TC0700X
PAPS-005679-L103TC2200X
PAPS-005769-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist