| Doctor Name: | MR. COREY EVONT EVANS |
| NPI Number: | 1649349655 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A. CCC-SLP |
| License Number: | SLP005335 |
| Business Practice Address: | 4097 Trotters Way Drive Snellville, GA - 30039 |
| Business Phone Number: | 4044497902 |
| Business Fax Number: | 7709797561 |
| Mailing Address: | P.o. Box 390335, SNELLVILLE |
| State: | GA |
| Postal Code: | 30039 |
| Phone Number: | 4044497902 |
| Fax Number: | 7709797561 |
| NPI Enumeration Date: | 11/06/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP005335 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| 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 |