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Individual

EVAN J DIVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PLMHP

Contact information

Practice address
245 S 84TH ST STE 212, LINCOLN, NE 68510-2600
(402) 261-9273
(402) 261-9274
Mailing address
PO BOX 1763, GRAND ISLAND, NE 68802-1763
(308) 395-1067
(308) 395-1060

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10533
NE

Other

Enumeration date
06/12/2015
Last updated
06/12/2015
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