| Karen A Evans Phd Llc | |
|
7061 Corporate Way Ste 110 Dayton OH 45459-4244 | |
| (937) 307-5949 | |
| Not Available |
| Full Name | Karen A Evans Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 7061 Corporate Way Ste 110, Dayton, Ohio |
| Authorized Official Name and Position | Karen A Evans (PSYCHOLOGIST) |
| Authorized Official Contact | 9373075949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Karen A Evans Phd Llc 6091 Single Tree Ln Dayton OH 45459-2423 Ph: (937) 307-5949 | Karen A Evans Phd Llc 7061 Corporate Way Ste 110 Dayton OH 45459-4244 Ph: (937) 307-5949 |
| NPI Number | 1659858157 |
|---|---|
| Provider Enumeration Date | 07/26/2018 |
| Last Update Date | 02/08/2019 |
| Medicare PECOS PAC ID | 2163766072 |
|---|---|
| Medicare Enrollment ID | O20181204002094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659858157 | NPI | - | NPPES |
| 0333760 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 5896 (Ohio) | Primary |
| Provider Name | Karen A Evans |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508877358 PECOS PAC ID: 4587848924 Enrollment ID: I20110411000212 |
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