Provider Demographics
NPI:1700018421
Name:EASON, EVAN ALLEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:ALLEN
Last Name:EASON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 BECCA CT
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-1499
Mailing Address - Country:US
Mailing Address - Phone:785-410-8185
Mailing Address - Fax:
Practice Address - Street 1:4121 BECCA CT
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-1499
Practice Address - Country:US
Practice Address - Phone:785-410-8185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2011-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist