Provider Demographics
NPI:1528668795
Name:EDWARDS, LAURA LYNN
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LYNN
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 1:1001 E 62ND AVE UNIT 590
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-1159
Mailing Address - Country:US
Mailing Address - Phone:720-297-8201
Mailing Address - Fax:
Practice Address - Street 1:1001 E 62ND AVE UNIT 590
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-1159
Practice Address - Country:US
Practice Address - Phone:720-297-8201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health