Basic Information
| Provider Information | |||||||||
| NPI: | 1194766881 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EVANS | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | MARY | ||||||||
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| Credential: | L.P.C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 W CHESTNUT ST | ||||||||
| Address2: | |||||||||
| City: | SELINSGROVE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178709414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703746870 | ||||||||
| FaxNumber: | 5709249492 | ||||||||
| Practice Location | |||||||||
| Address1: | 1800 MARKET ST | ||||||||
| Address2: | |||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178371236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705249477 | ||||||||
| FaxNumber: | 5705249492 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | PC000762 | PA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.