Individual
LEILA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
318 W PIKE ST, SUITE 104, LAWRENCEVILLE, GA 30045-3234
(678) 377-2833
(678) 377-2882
Mailing address
318 W PIKE ST, SUITE 104, LAWRENCEVILLE, GA 30045-3234
(678) 377-2833
(678) 377-2882
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006940
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
852476861A
—
GA
Enumeration date
01/14/2009
Last updated
01/14/2009
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