Provider Demographics
NPI:1346404548
Name:TARUD, EVELYN CRISTINA (LMHC)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:CRISTINA
Last Name:TARUD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9680 FAIRGROUNDS RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-3528
Mailing Address - Country:US
Mailing Address - Phone:561-333-0664
Mailing Address - Fax:
Practice Address - Street 1:9680 FAIRGROUNDS RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3528
Practice Address - Country:US
Practice Address - Phone:561-333-0664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9431101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH9431OtherFLORIDA DEPARTMENT OF HEALTH