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Individual

DR. LEOLA EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2300 WASHINGTON PINE NE103, WASHINGTON, DC 20018
(757) 742-2327
Mailing address
2228 GOLDEN GARDEN CIR, CHESTER, VA 23836-6217
(757) 742-2327

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YP1600X
Pastoral Counselor
172V00000X
Community Health Worker
374U00000X
Home Health Aide
Primary
376J00000X
Homemaker
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
T64703610
DRIVERS LICENSES
VA
01
T64703610
DRIVERS LICENSE
Enumeration date
09/16/2022
Last updated
09/16/2022
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