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General NPI Number Information
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NPI Number | 1518144583
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Entity Type | Individual
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Provider Name | SHELBY EVANS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 8100 E 22ND ST N STE 1600-B
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City | WICHITA
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State | KS
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Zip | 67226-2388
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Country | US
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Telephone | 316-201-6462
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Fax | 316-201-6428
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Provider Business Mailing Address
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Address Line | 8100 E 22ND ST N STE 1600-B
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City | WICHITA
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State | KS
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Zip | 67226-2388
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Country | US
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Telephone | 316-201-6462
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Fax | 316-201-6428
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1921
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1073513
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License Number State |
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