Provider Demographics
NPI:1578709366
Name:EVANS, JOAN E (AUD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:E
Last Name:EVANS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MEADE RD
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5123
Mailing Address - Country:US
Mailing Address - Phone:610-755-9416
Mailing Address - Fax:610-539-7411
Practice Address - Street 1:24 MEADE RD
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5123
Practice Address - Country:US
Practice Address - Phone:610-755-9416
Practice Address - Fax:610-539-7411
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-28
Last Update Date:2008-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000210L231H00000X
PASL000881L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist