Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1078 | SC |
Y | 103TC0700X | Clinical Psychologist | 1078 | SC |
N | 102L00000X | Psychologist | 1078 | SC |
N | 103T00000X | Psychologist | 1078 | SC |
N | 102L00000X | Psychologist | 3561 | NC |
N | 103T00000X | Psychologist | 3561 | NC |
NPI | 1013176882 |
---|---|
Provider Name | Dr. Victoria P Evans |
First Address | Rock Hill, SC 29730-3579 |
Second Address | Rock Hill, SC 29730-3579 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 05/06/2008 |