Basic Information
| Provider Information | |||||||||
| NPI: | 1811541352 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EDWARDS | ||||||||
| FirstName: | ASHLEIGH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 74 EAST ST | ||||||||
| Address2: | |||||||||
| City: | PLAINVILLE | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060622367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607934448 | ||||||||
| FaxNumber: | 8607933369 | ||||||||
| Practice Location | |||||||||
| Address1: | 43 WOODLAND ST | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061052363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607934448 | ||||||||
| FaxNumber: | 8606454132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2019 | ||||||||
| LastUpdateDate: | 09/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.