Individual
CLYDE PRESTON EVELY JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
180 PROVIDENCE RD, SUITE 4, CHAPEL HILL, NC 27514-2206
(919) 493-4400
Mailing address
180 PROVIDENCE RD, SUITE 4, CHAPEL HILL, NC 27514-2206
(919) 493-4400
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1994
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046J1
BLUECROSS
NC
01
—
2107748
CIGNA
NC
05
—
6000610
—
NC
Enumeration date
06/06/2006
Last updated
07/08/2007
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