Individual
MRS. THEONIE PAPPAS EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
5407 N CHARLES ST, BALTIMORE, MD 21210-2024
(410) 433-8861
(410) 433-1249
Mailing address
5407 N CHARLES ST, BALTIMORE, MD 21210-2024
(410) 433-8861
(410) 433-1249
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LC3323
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207L
MEDICARE PTAN
MD
Enumeration date
10/20/2011
Last updated
10/20/2011
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