Provider Demographics
NPI:1851962633
Name:EDWARDS, TIA WILLIAMS (M ED)
Entity Type:Individual
Prefix:MS
First Name:TIA
Middle Name:WILLIAMS
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7516 BLUEBONNET BLVD. #111
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1627
Mailing Address - Country:US
Mailing Address - Phone:225-235-0555
Mailing Address - Fax:
Practice Address - Street 1:9238 STARING COURT
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2622
Practice Address - Country:US
Practice Address - Phone:225-235-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion
No374700000XNursing Service Related ProvidersTechnician
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider