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General NPI Number Information
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NPI Number | 1346877669
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Entity Type | Individual
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Provider Name | DEVIN EVANS
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Gender | Female
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Dates
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Enumeration Date | 03/25/2020
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Last Update Date | 03/25/2020
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Provider Practice Location Address
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Address Line | 880 S PLEASANTBURG DR STE 4E
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City | GREENVILLE
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State | SC
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Zip | 29607-2453
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Country | US
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Telephone | 864-249-4495
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Fax |
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Provider Business Mailing Address
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Address Line | 201 WILD WING WAY
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City | EASLEY
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State | SC
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Zip | 29642-8022
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Country | US
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Telephone | 904-535-4520
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7193
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License Number State | SC
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