Provider Demographics
NPI:1295138345
Name:EDWARDS, KALYN BRICE (M ED CFY- SLP)
Entity type:Individual
Prefix:MS
First Name:KALYN
Middle Name:BRICE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:M ED CFY- SLP
Other - Prefix:MS
Other - First Name:BRICE
Other - Middle Name:
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED CFY- SLP
Mailing Address - Street 1:1491 OLD BEACON LIGHT RD
Mailing Address - Street 2:
Mailing Address - City:HARTWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30643-3921
Mailing Address - Country:US
Mailing Address - Phone:706-371-2152
Mailing Address - Fax:
Practice Address - Street 1:1964 OAKWAY RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:SC
Practice Address - Zip Code:29693-5938
Practice Address - Country:US
Practice Address - Phone:864-886-4505
Practice Address - Fax:864-886-4506
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist