Individual
PAUL EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
4450 W EAU GALLIE BLVD, 200, MELBOURNE, FL 32934-7213
(321) 752-3100
Mailing address
4450 W EAU GALLIE BLVD, 200, MELBOURNE, FL 32934-7213
(321) 752-3100
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
LCMFT0241021200
FL
171M00000X
Case Manager/Care Coordinator
Primary
LCMFT0241021200
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076542200
—
FL
05
—
768243300
—
FL
Enumeration date
03/07/2007
Last updated
01/15/2016
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