Provider Demographics
NPI:1225162357
Name:EDWARDS, BRIAN (MS)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 PRESTON RUN
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-1954
Mailing Address - Country:US
Mailing Address - Phone:818-635-8427
Mailing Address - Fax:
Practice Address - Street 1:4104 PRESTON RUN
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1954
Practice Address - Country:US
Practice Address - Phone:818-635-8427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist