Individual
MR. MAVERICK BENJAMIN EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC-I
Contact information
Practice address
1001 WALLACE BLVD, AMARILLO, TX 79106-1735
(888) 236-4567
Mailing address
1001 WALLACE BLVD, AMARILLO, TX 79106-1735
(888) 236-4567
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
64910
TX
Other
Enumeration date
02/23/2024
Last updated
02/23/2024
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