Provider Demographics
NPI:1114448982
Name:EDWARDS, CLAIRE RHODES (CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:CLAIRE
Middle Name:RHODES
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BLACK DUCK DR
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617-2725
Mailing Address - Country:US
Mailing Address - Phone:410-829-1607
Mailing Address - Fax:
Practice Address - Street 1:235 ASHLEY AVE APT B
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5494
Practice Address - Country:US
Practice Address - Phone:410-829-1607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6262235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty