Individual
MISS MONA KAY EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
998 E GANNON DR, SUITE 120, FESTUS, MO 63028-2663
(636) 931-2900
Mailing address
998 E GANNON DR, SUITE 120, FESTUS, MO 63028-2663
(636) 931-2900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002060
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407886864
—
MO
05
—
756964508
—
MO
Enumeration date
07/03/2006
Last updated
04/29/2014
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