Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1114216835 |
---|---|
Provider Name | Ms. Sandra L. Evans |
First Address | Florence, SC 29501-3925 |
Second Address | Sumter, SC 29150-2553 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2011 |
Last Update Date | 04/04/2011 |