Provider Demographics
NPI:1538458872
Name:EVANS, NATALIE JONES (MS,CCC- SLP)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:JONES
Last Name:EVANS
Suffix:
Gender:F
Credentials:MS,CCC- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 N GALLOWAY AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-4364
Mailing Address - Country:US
Mailing Address - Phone:214-988-5437
Mailing Address - Fax:800-921-7173
Practice Address - Street 1:309 N GALLOWAY AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-4364
Practice Address - Country:US
Practice Address - Phone:214-988-5437
Practice Address - Fax:800-921-7173
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105978235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist