Individual provider · NPI-1

Crystal P Evans

Developmental Therapist · Little Rock, AR

NPI number1306110168
StatusActive
Last updated in NPPESFeb 25, 2012

Details

NPI
1306110168
Entity type
Individual (NPI-1)
Name
Mrs. Crystal P Evans
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 25, 2012
Last updated
Feb 25, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
222Q00000X Developmental Therapist–ARYes

Practice location

6323 Colonel Glenn Rd Ste 108
Little Rock, AR 72204-7757

Phone 501-569-9092 · Fax 501-569-9018

Mailing address

42 Wedgeside Dr
Little Rock, AR 72210-4138

Phone 501-541-8905 · Fax 501-379-8988

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