Individual
MR. JEFFREY JOHN EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., CCC-SLP
Contact information
Practice address
11201 WASHBURN AVE S, BLOOMINGTON, MN 55431-3833
(952) 888-7699
(952) 888-7699
Mailing address
11201 WASHBURN AVE S, BLOOMINGTON, MN 55431-3833
(952) 888-7699
(952) 888-7699
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7275
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7275
MINNESOTA DEPARTMENT OF HEALTH
MN
Enumeration date
09/27/2008
Last updated
09/27/2008
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