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SUSAN M EVANS PH.D.

Clinical Neuropsychologist

Edinboro, Pennsylvania

Provider NPI: 1881690063

Provider Information:
 SUSAN M EVANS PH.D.
Gender: F
Sole Proprietor


Practice Location:
12634 ANGLING RD  EDINBORO, PA 16412 US
Tel: 814-449-7542  Fax: --

Business Mailing Address:
12634 ANGLING RD  EDINBORO, PA 16412 US
Tel: --  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
PAPS-005771-L
Y103TC1900XBehavioral Health & Social Service Providers
Psychologist
PAPS005771L

Other Provider Identifiers:

IssuerNumberStateType
1013543460003PA05
1013543460004PA05
1013543460005PA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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