Individual
CHRISTINA B EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
313 SOUTH AVE STE 406, SPRINGFIELD, MO 65806-3080
(417) 242-9644
(417) 889-6307
Mailing address
3419 W REGAL CT, SPRINGFIELD, MO 65807-2124
(417) 242-9644
(417) 889-6307
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2010037956
MO
101YM0800X
Mental Health Counselor
Primary
2010037956
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164517934
NPI
MO
05
—
503743502
—
MO
Enumeration date
11/05/2010
Last updated
03/17/2018
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