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Individual
MS. TERESE W EVANS
Active
Individual
MS. TERESE W EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2003023374
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178679
BLUE CROSS BLUS SHIELD
MO
Enumeration date
12/18/2006
Last updated
07/09/2007
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