Individual
MICHELLE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E ELM ST, PONCHATOULA, LA 70454
(985) 956-7823
Mailing address
400 E ELM ST, PONCHATOULA, LA 70454-2465
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/17/2015
Last updated
05/31/2018
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