Healthcare Provider Details

I. General information

NPI: 1295046183
Provider Name (Legal Business Name): ROYE T EVANS LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 DORSEY HALL DR STE 201
ELLICOTT CITY MD
21042-7749
US

IV. Provider business mailing address

4801 DORSEY HALL DR STE 201
ELLICOTT CITY MD
21042-7749
US

V. Phone/Fax

Practice location:
  • Phone: 410-997-5191
  • Fax:
Mailing address:
  • Phone: 410-997-5191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU02451
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: