| Doctor Name: | MISS FARRELL M EVANS |
| NPI Number: | 1275877060 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CDS III |
| License Number: | NWIADSCB09/1711CCP |
| Business Practice Address: | 100 Eagle Feather Street Lame Deer, MT - 59043 |
| Business Phone Number: | 4064774924 |
| Business Fax Number: | 4064776727 |
| Mailing Address: | Po Box 135, 836 Bravewolf BUSBY |
| State: | MT |
| Postal Code: | 590160135 |
| Phone Number: | 4064774910 |
| Fax Number: | 4064778727 |
| NPI Enumeration Date: | 11/16/2012 |
| NPI Last Update Date: | 11/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | NWIADSCB09/1711CCP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |