Provider Demographics
NPI:1255844619
Name:EDWARDS, LASHONDA (PCA)
Entity Type:Individual
Prefix:
First Name:LASHONDA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4920 HARD SCRABBLE RD APT 406
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9368
Mailing Address - Country:US
Mailing Address - Phone:803-238-5341
Mailing Address - Fax:803-708-0000
Practice Address - Street 1:4920 HARD SCRABBLE RD APT 406
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-9368
Practice Address - Country:US
Practice Address - Phone:803-238-5341
Practice Address - Fax:803-708-0000
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health