Doctor Name: | ROBERT S EVANS |
NPI Number: | 1386790442 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S., CCC-SLP |
License Number: | 4302 |
Business Practice Address: | 114 Willow Trace Cir Apt 5 Clemmons, NC - 270128814 |
Business Phone Number: | 3366822730 |
Business Fax Number: | 3366822730 |
Mailing Address: | 114 Willow Trace Cir Apt 5, CLEMMONS |
State: | NC |
Postal Code: | 270128814 |
Phone Number: | 3366822730 |
Fax Number: | 3366822730 |
NPI Enumeration Date: | 01/25/2007 |
NPI Last Update Date: | 05/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4302 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |