Provider Demographics
NPI:1962644187
Name:EDWARDS, ANNABEL ROSE (MFT)
Entity Type:Individual
Prefix:MS
First Name:ANNABEL
Middle Name:ROSE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87-3190 EA RD
Mailing Address - Street 2:
Mailing Address - City:CAPTAIN COOK
Mailing Address - State:HI
Mailing Address - Zip Code:96704-8715
Mailing Address - Country:US
Mailing Address - Phone:808-328-2307
Mailing Address - Fax:
Practice Address - Street 1:74-381 KEALAKEHE PKWY
Practice Address - Street 2:STE G
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2705
Practice Address - Country:US
Practice Address - Phone:808-756-1372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI42106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist