Individual
MS. JUAN Z EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA-L
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 605-8869
Mailing address
3072 FLEETWOOD DR, JACKSON, MS 39212-2545
(601) 346-5555
(601) 351-8229
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA1660
MS
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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