| NPI | 1689311797 |
|---|---|
| Professional Name | EDRIS F LODGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: LA EL860039) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2023-07-13 |