Doctor Name: | MS. DANA JACQUELINE EVANS |
NPI Number: | 1912214073 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.P.C. |
License Number: | LPC-4405 |
Business Practice Address: | 7424 Apennines Dr Ft Riley, KS - 664427151 |
Business Phone Number: | 7852402716 |
Business Fax Number: | |
Mailing Address: | 3922 Forrest Creek Cir, MANHATTAN |
State: | KS |
Postal Code: | 665037598 |
Phone Number: | 2084043715 |
Fax Number: | |
NPI Enumeration Date: | 09/09/2010 |
NPI Last Update Date: | 11/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC-4405 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |