Provider Demographics
NPI:1033752100
Name:EDWARDS, TASHONDA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:TASHONDA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-0878
Mailing Address - Country:US
Mailing Address - Phone:409-739-2701
Mailing Address - Fax:
Practice Address - Street 1:1828 WREN DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5131
Practice Address - Country:US
Practice Address - Phone:409-739-2701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health