Provider Demographics
NPI:1114496494
Name:EVANS, DEBRA (CIT)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6084 APPLE TREE DR STE 10
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-0305
Mailing Address - Country:US
Mailing Address - Phone:901-207-4804
Mailing Address - Fax:901-255-0758
Practice Address - Street 1:6084 APPLE TREE DR STE 10
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-0305
Practice Address - Country:US
Practice Address - Phone:901-207-4804
Practice Address - Fax:901-255-0758
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor