Provider Demographics
NPI:1295877025
Name:EDWARDS, BETTY JANE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:JANE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9035 SW 104TH LN
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-9420
Mailing Address - Country:US
Mailing Address - Phone:352-229-2888
Mailing Address - Fax:
Practice Address - Street 1:9035 SW 104TH LN
Practice Address - Street 2:34 SW 32 AVE
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-9420
Practice Address - Country:US
Practice Address - Phone:352-229-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0004442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health