Provider Demographics
NPI:1093172835
Name:EDWARDS, RANDI HUTCHINSON (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:HUTCHINSON
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2086 HIGHWAY 14
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MS
Mailing Address - Zip Code:39095-6208
Mailing Address - Country:US
Mailing Address - Phone:662-834-2781
Mailing Address - Fax:
Practice Address - Street 1:2086 HIGHWAY 14
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MS
Practice Address - Zip Code:39095-6208
Practice Address - Country:US
Practice Address - Phone:662-834-2781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS2141235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist