Provider Demographics
NPI:1649612821
Name:HARO-BRISTER, EVELYN (MA, LPC)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:HARO-BRISTER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 S GEORGIA ST STE C-2
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-4800
Mailing Address - Country:US
Mailing Address - Phone:915-330-7388
Mailing Address - Fax:
Practice Address - Street 1:3601 S GEORGIA ST STE C-2
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-4800
Practice Address - Country:US
Practice Address - Phone:806-418-2208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67714101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional