Individual
MONIQUE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
142 NEW ROADS ST, NEW ROADS, LA 70760-3508
(225) 618-9955
Mailing address
PO BOX 732, NEW ROADS, LA 70760-0732
(225) 618-9955
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5682
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1509353
—
LA
Enumeration date
04/26/2007
Last updated
07/08/2007
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