Individual
EVELYN SOUTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASE MANAGER
Contact information
Practice address
2530 S COMMERCE, ARDMORE, OK 73401-0189
(580) 223-5070
(580) 223-5617
Mailing address
PO BOX 189, ARDMORE, OK 73402-0189
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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