Provider Demographics
NPI:1447636576
Name:EDWARDS, ANDREA MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 N MELWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2951
Mailing Address - Country:US
Mailing Address - Phone:520-904-6076
Mailing Address - Fax:
Practice Address - Street 1:7750 E BROADWAY BLVD STE A100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3901
Practice Address - Country:US
Practice Address - Phone:520-327-1529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X390200000X
AZ6841T106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program