Provider Demographics
NPI:1265232979
Name:EDWARDS, MARVA JOHNSON (CPSS)
Entity type:Individual
Prefix:MRS
First Name:MARVA
Middle Name:JOHNSON
Last Name:EDWARDS
Suffix:
Gender:
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2878
Mailing Address - Country:US
Mailing Address - Phone:336-897-0037
Mailing Address - Fax:
Practice Address - Street 1:122 N ELM ST STE 512
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2818
Practice Address - Country:US
Practice Address - Phone:336-897-0037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist