Healthcare Provider Details

I. General information

NPI: 1427672492
Provider Name (Legal Business Name): SARA CHRISTINE EVATT MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA CHRISTINE COCHRAN

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 INDUSTRIAL DR
MOUNTAIN VIEW AR
72560-8872
US

IV. Provider business mailing address

301 INDUSTRIAL DR
MOUNTAIN VIEW AR
72560-8872
US

V. Phone/Fax

Practice location:
  • Phone: 870-269-6022
  • Fax:
Mailing address:
  • Phone: 702-698-6022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberP2309002
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2020033344
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: