Individual
MARY BETH EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
114 COUNTRY CLUB RD, SHERWOOD, AR 72120-4625
(501) 834-2727
Mailing address
4355 SPRING GLEN DR, SHERWOOD, AR 72120-5112
(501) 650-4925
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2245-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149004401
101Y00000X
IL
Enumeration date
02/13/2007
Last updated
04/20/2015
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