Provider Demographics
NPI:1447436381
Name:EDWARDS, WENDY (LAPC)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:EDWARDS
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAPC
Mailing Address - Street 1:2130 HIGHVIEW RD SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-2539
Mailing Address - Country:US
Mailing Address - Phone:678-480-8310
Mailing Address - Fax:
Practice Address - Street 1:2130 HIGHVIEW RD SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-2539
Practice Address - Country:US
Practice Address - Phone:678-480-8310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC001287101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor