Provider Demographics
NPI:1558198697
Name:EDWARDS, NANCY ANN (SLPA)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 E 17TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8519
Mailing Address - Country:US
Mailing Address - Phone:714-494-7551
Mailing Address - Fax:
Practice Address - Street 1:1535 E 17TH ST STE 104
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8519
Practice Address - Country:US
Practice Address - Phone:714-494-7551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2355S0801X
CA2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant