Provider Demographics
NPI:1992172936
Name:EDWARDS, ELIZABETH HAWKINS (MA, LCAT, RDT)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:HAWKINS
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MA, LCAT, RDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 N 7TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-3005
Mailing Address - Country:US
Mailing Address - Phone:615-479-5499
Mailing Address - Fax:
Practice Address - Street 1:67 N 7TH ST APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-3005
Practice Address - Country:US
Practice Address - Phone:615-479-5499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05 001789221700000X, 225600000X, 225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist