Provider Demographics
NPI:1720842693
Name:PAREDES, EDWIN ALEXIS
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:ALEXIS
Last Name:PAREDES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 DAVIDSON ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-3820
Mailing Address - Country:US
Mailing Address - Phone:336-970-8302
Mailing Address - Fax:
Practice Address - Street 1:1114 EASTCHESTER DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3114
Practice Address - Country:US
Practice Address - Phone:336-802-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician