Provider Information for 1366093569
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TERRI MARIE EVANS LPC
Sex: Female
NPI: 1366093569
Last Updated: 2024-04-15
Certification Date: 2024-04-15
Certification Date: 2024-04-15
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1366093569 | ||||||||||||
| Enumeration Date | 2019-09-28 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1016 WEXLER ST SAVANNAH, GA 31415-5272 United States Phone: 912-433-4591 | Fax: | ||||||||||||
| Primary Practice Address | 10500 ABERCORN STREET SUITE C SAVANNAH, GA 31419-1156 United States Phone: 912-433-4591 | Fax: | ||||||||||||
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