| Doctor Name: | MS. KENYETTA EVANS |
| NPI Number: | 1851762926 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | ADC842 |
| Business Practice Address: | 129 Clark St Grove Hill, AL - 364513050 |
| Business Phone Number: | 2512754165 |
| Business Fax Number: | |
| Mailing Address: | 223 Belmont Rd, DIXONS MILLS |
| State: | AL |
| Postal Code: | 367362855 |
| Phone Number: | 2053108033 |
| Fax Number: | |
| NPI Enumeration Date: | 10/14/2015 |
| NPI Last Update Date: | 10/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | ADC842 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |