Individual
EVONNA SURRETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
315 HIGHLAND SHORES DR, 4D, LAKE OZARK, MO 65049-8739
(479) 747-7980
Mailing address
PO BOX 1352, LAKE OZARK, MO 65049-1352
(479) 747-7980
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2014032286
MO
101YM0800X
Mental Health Counselor
9959
NE
Other
Enumeration date
09/15/2013
Last updated
02/02/2017
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