Provider Demographics
NPI:1548352172
Name:EDWARDS, ANNE LOUISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:LOUISE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4317 SOUTHMOOR PARK
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40514-1815
Mailing Address - Country:US
Mailing Address - Phone:859-229-6753
Mailing Address - Fax:
Practice Address - Street 1:841 CORPORATE DR
Practice Address - Street 2:SUITE 204
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-5421
Practice Address - Country:US
Practice Address - Phone:859-229-6753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1277103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical