| Doctor Name: | MR. DWIGHT DANIEL EVANS |
| NPI Number: | 1316251549 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, M.DIV., LPC |
| License Number: | PC004180 |
| Business Practice Address: | 133 Switzgabel Dr Brodheadsville, PA - 183227120 |
| Business Phone Number: | 5704016378 |
| Business Fax Number: | |
| Mailing Address: | 64 Iowa Rd, ALBRIGHTSVILLE |
| State: | PA |
| Postal Code: | 182103622 |
| Phone Number: | 5704016378 |
| Fax Number: | |
| NPI Enumeration Date: | 07/29/2010 |
| NPI Last Update Date: | 05/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC004180 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |