Individual
EVAN ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC, LICDC
Contact information
Practice address
53 W MAIN ST, XENIA, OH 45385-2979
(937) 971-2350
Mailing address
PO BOX 55, WALTON, KY 41094-0055
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E1100146
OH
Other
Enumeration date
11/01/2016
Last updated
12/03/2021
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