Provider Information for 1942509591
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MICHELLE FAYE EVANS LPC
Sex: Female
NPI: 1942509591
Last Updated: 2019-09-26
Certification Date:
Certification Date:
Details
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NPI | 1942509591 | ||||||||
Enumeration Date | 2011-03-22 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 1800 COMMUNITY CLINTON, MO 64735-8804 United States Phone: 660-885-8131 | Fax: | ||||||||
Primary Practice Address | 1450 E 10TH ST ROLLA, MO 65401-3648 United States Phone: 888-403-1071 | Fax: | ||||||||
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