Provider Demographics
NPI:1033538194
Name:EDWARDS, SARAH R (LP, PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:R
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5062 120TH AVE N
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:MN
Mailing Address - Zip Code:56536-9326
Mailing Address - Country:US
Mailing Address - Phone:815-762-6292
Mailing Address - Fax:
Practice Address - Street 1:3309 FIECHTNER DR S STE H
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-2375
Practice Address - Country:US
Practice Address - Phone:218-303-6164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND496103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist