Provider Demographics
NPI:1235670274
Name:EVANS, HOPE (MS SLP/CCC)
Entity Type:Individual
Prefix:MISS
First Name:HOPE
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:MS SLP/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8927 SHELLFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-5375
Mailing Address - Country:US
Mailing Address - Phone:901-246-8233
Mailing Address - Fax:
Practice Address - Street 1:1905 GROVE ST
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39183-3104
Practice Address - Country:US
Practice Address - Phone:901-246-8233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSSO831235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist