Individual
JESSICA ELIZABETH EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT MMT
Contact information
Practice address
4200 GLENDALE RD, KENLY, NC 27542-9757
(919) 841-6742
Mailing address
4200 GLENDALE RD, KENLY, NC 27542-9757
(919) 841-6742
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10524
NC
Other
Enumeration date
03/11/2013
Last updated
11/30/2022
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