Doctor Name: | MRS. ANGELA L. EVANS |
NPI Number: | 1366507634 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., LCPC, CADC |
License Number: | |
Business Practice Address: | 1029 W Prairie St Taylorville, IL - 625682008 |
Business Phone Number: | 2178270737 |
Business Fax Number: | |
Mailing Address: | 1029 W Prairie St, TAYLORVILLE |
State: | IL |
Postal Code: | 625682008 |
Phone Number: | 2178270737 |
Fax Number: | |
NPI Enumeration Date: | 12/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |