Individual
JASON EVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
10301 FALLS MILL DR APT 207, RALEIGH, NC 27614-6433
(919) 436-6158
Mailing address
10301 FALLS MILL DR APT 207, RALEIGH, NC 27614-6433
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1454
NC
Other
Enumeration date
07/16/2012
Last updated
02/25/2013
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