Provider Demographics
NPI:1508521436
Name:EVANS, JAWANNA MONAE
Entity Type:Individual
Prefix:MS
First Name:JAWANNA
Middle Name:MONAE
Last Name:EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8766 KYLE CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3862
Mailing Address - Country:US
Mailing Address - Phone:334-652-8522
Mailing Address - Fax:
Practice Address - Street 1:8766 KYLE CT
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3862
Practice Address - Country:US
Practice Address - Phone:334-652-8522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker