Individual
EVAN APPLEGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1151 N STATE ST STE 212, JACKSON, MS 39202-2467
(601) 352-7398
Mailing address
4110 CRANE BLVD, JACKSON, MS 39216-3405
(601) 668-2570
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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