Individual
ELIZABETH G EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1600 MEDICAL CENTER DR, SUITE B500, HUNTINGTON, WV 25701-3656
(304) 691-1500
(304) 691-1510
Mailing address
1600 MEDICAL CENTER DR, SUITE B500, HUNTINGTON, WV 25701-3656
(304) 691-1500
(304) 691-1510
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
442
WV
103TS0200X
School Psychologist
22037
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163537001
—
WV
05
—
0813712
—
OH
Enumeration date
03/29/2006
Last updated
01/19/2011
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