Provider Demographics
NPI:1780712349
Name:EVANS, STEPHANIE DAWN HIGHSMITH (BS)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:DAWN HIGHSMITH
Last Name:EVANS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-5168
Mailing Address - Country:US
Mailing Address - Phone:615-384-0975
Mailing Address - Fax:
Practice Address - Street 1:714 CHEATHAM ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-2829
Practice Address - Country:US
Practice Address - Phone:615-463-6220
Practice Address - Fax:615-463-6202
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional