Provider Demographics
NPI:1366630048
Name:EDWARDS, MAURA M (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:M
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 1:126 BRASS OAK DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8328
Mailing Address - Country:US
Mailing Address - Phone:256-837-0385
Mailing Address - Fax:
Practice Address - Street 1:5275 MILLENNIUM DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-2457
Practice Address - Country:US
Practice Address - Phone:256-489-6800
Practice Address - Fax:256-489-6520
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1124235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist