Provider Demographics
NPI:1902181845
Name:EDMONDSON, MAEYER (REIKI PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:MAEYER
Middle Name:
Last Name:EDMONDSON
Suffix:
Gender:F
Credentials:REIKI PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-4214
Mailing Address - Country:US
Mailing Address - Phone:505-425-1442
Mailing Address - Fax:505-425-1442
Practice Address - Street 1:926 8TH ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4214
Practice Address - Country:US
Practice Address - Phone:505-425-1442
Practice Address - Fax:505-425-1442
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist