Provider Demographics
NPI:1700288651
Name:EVANS, KARLA (PSYD)
Entity type:Individual
Prefix:DR
First Name:KARLA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:
Other - Last Name:HOLYFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:4108 WATER PARK CIR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-9110
Mailing Address - Country:US
Mailing Address - Phone:972-938-6702
Mailing Address - Fax:
Practice Address - Street 1:4108 WATER PARK CIR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-9110
Practice Address - Country:US
Practice Address - Phone:972-938-6702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36641103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist