Individual
LARRY EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
1654 E UNION ST, GREENVILLE, MS 38703-3250
(662) 335-5274
(662) 378-3976
Mailing address
1654 E UNION ST, GREENVILLE, MS 38703-3250
(662) 335-5274
(662) 378-3976
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018205
—
MS
Enumeration date
12/27/2007
Last updated
12/27/2007
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