Provider Demographics
NPI:1992950083
Name:EVANS, KARA MICHELLE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MICHELLE
Last Name:EVANS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 KNOLL RD
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-9506
Mailing Address - Country:US
Mailing Address - Phone:605-641-6915
Mailing Address - Fax:
Practice Address - Street 1:555 KNOLL RD
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-9506
Practice Address - Country:US
Practice Address - Phone:605-641-6915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist