Individual
MRS. COURTNEY TARA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LCM HC-S, NCC
Contact information
Practice address
718 WASHINGTON STREET, EDEN, NC 27288
(336) 613-8351
Mailing address
125 GLEN OAK DRIVE, EDEN, NC 27288
(336) 613-8351
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
A11202
NC
101Y00000X
Counselor
Primary
S-11202
NC
Other
Enumeration date
06/15/2015
Last updated
01/17/2022
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