Provider Information for 1255868444
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CARLA EVANS LGPC
Sex: Female
NPI: 1255868444
Last Updated: 2019-12-13
Certification Date: 2019-12-13
Certification Date: 2019-12-13
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1255868444 | ||||||||
| Enumeration Date | 2017-05-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5402 AUTH RD APT 530 SUITLAND, MD 20746-4389 United States Phone: 301-747-3345 | Fax:240-838-7001 | ||||||||
| Primary Practice Address | 5402 AUTH RD APT 530 SUITLAND, MD 20746-4389 United States Phone: 301-747-3345 | Fax:240-838-7001 | ||||||||
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