Edwards, Gene Randolph

Edwards, Gene Randolph is an sole proprietor health care provider with primary practice located at 1923 J N Pease Pl Suite 204, Charlotte NC 28262-4513. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Edwards, Gene Randolph can be contacted via phone (704) 503-3535.

Contact Information

Primary practice address
1923 J N Pease Pl Suite 204 Charlotte NC 28262-4513
Phone: (704) 503-3535
Fax: (704) 593-5555
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X 3660 North Carolina

Profile Details

NPI number 1659628030
LBN Legal business name Edwards, Gene Randolph
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2012
Last updated Aug 5th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659628030 NPPES
North Carolina Other 3660 NC PSYCHOLOGY BOARD LICENSE NUMBER

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