Basic Information
| Provider Information | |||||||||
| NPI: | 1851728513 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EDWARDS | ||||||||
| FirstName: | HOLLY | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 741 DELAWARE AVE | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142092201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7162181400 | ||||||||
| FaxNumber: | 7163322820 | ||||||||
| Practice Location | |||||||||
| Address1: | 3719 UNION RD | ||||||||
| Address2: | SUITE 214 | ||||||||
| City: | CHEEKTOWAGA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142254249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166817394 | ||||||||
| FaxNumber: | 7166859087 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2013 | ||||||||
| LastUpdateDate: | 09/26/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 00084029 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.