Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LC4226 | MD |
N | 101YS0200X | School Counselor | 13-9188 | MD |
NPI | 1194076323 |
---|---|
Provider Name | Farah Maria Evans |
First Address | Towson, MD 21286-8317 |
Second Address | Towson, MD 21286-8317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2012 |
Last Update Date | 12/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LC4226 | BOARD OF PROFESSIONAL COUNSELORS & THERAPIST (01) | MD |