Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 38744 | TX |
Y | 103TC0700X | Clinical Psychologist | 38744 | TX |
NPI | 1003585845 |
---|---|
Provider Name | Julia Evans |
First Address | Dallas, TX 75216-7167 |
Second Address | Dallas, TX 75216-7167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2021 |
Last Update Date | 07/09/2021 |