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DIANE R EDWARDS NPI 1538366075


NPI Information

NPI: 1538366075
Provider Name: DIANE R EDWARDS

Other Name: DEVELPMENTAL PEDIATRIC SERVICES

Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
915 S DAVID ST
CASPER, WY
ZIP 82601
Phone: (307) 472-3769
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DIANE R EDWARDS is a counselor in Casper, WY. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. DIANE R EDWARDS NPI is 1538366075. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Develpmental Pediatric Services.

The provider's business location address is:

915 S DAVID ST
CASPER, WY
ZIP 82601-737
Phone: (307) 472-3769
Fax: (307) 472-3607

The provider's authorized official is Diane Rose Edwards .
The authorized official title is Owner and has the following contact phone number (307) 472-3769.

The enumeration date for this NPI number is 6/28/2007 and was last updated on 7/27/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1112255000MEDICAIDWYOMING
21003982141OTHERWYOMINGNPI
3304479MEDICARE ID-TYPE UNSPECIFIEDWYOMING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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