Individual
MR. BARRY LEROY EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MASTER SOCIAL WORK
Contact information
Practice address
1125 6TH STREET SE, WOODLAND CENTERS, WILLMAR, MN 56201-4675
(320) 231-9148
(320) 231-9140
Mailing address
5285 COUNTY ROAD 4 NE, ATWATER, MN 56209
(320) 235-4613
(320) 231-9140
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
391
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013109
PREFERRED ONE
—
01
—
115671
UCARE
—
01
—
30024EV
BLUE CROSS
—
01
—
6220225
UBH
—
Enumeration date
12/06/2006
Last updated
07/08/2007
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