Provider Demographics
NPI:1427724087
Name:EDWARDS, DENISE P
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:P
Last Name:EDWARDS
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 1:4325 GREED RD, COTTAGE3
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-4884
Mailing Address - Country:US
Mailing Address - Phone:330-467-7131
Mailing Address - Fax:330-467-2915
Practice Address - Street 1:4325 GREED RD, COTTAGE3
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-4884
Practice Address - Country:US
Practice Address - Phone:330-467-7131
Practice Address - Fax:330-467-2915
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator