Provider Demographics
NPI:1336512078
Name:BARRAZA EVANS, CARLA IDALIA
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:IDALIA
Last Name:BARRAZA EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:IDALIA
Other - Last Name:BARRAZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2740 IBERVILLE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5516
Mailing Address - Country:US
Mailing Address - Phone:504-821-8184
Mailing Address - Fax:504-821-8185
Practice Address - Street 1:2740 IBERVILLE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5516
Practice Address - Country:US
Practice Address - Phone:504-821-8184
Practice Address - Fax:504-821-8185
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor