Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK MICHAEL EVANS, MA, BCBA
Active Sole ProprietorJACK MICHAEL EVANS, MA, BCBA is a Behavior Analyst healthcare provider located in LOUISA, Kentucky. NPI 1306594916 is currently active in the NPPES registry. Verify at CMS.
Behavior Analyst · LOUISA, KY
Registration Details
- NPI Number
- 1306594916
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 13, 2022 (4.3826438265457 yrs)
- Last Updated
- Mar 5, 2024
- Licenses
-
1-20-41236276596 (KY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
125 S MAIN CROSS STLOUISA, KY, 412301065Browse KY providers · Browse ZIP 41230
- Phone
- 6066380938
- Primary Specialty
-
Behavior Analyst
103K00000X
- Additional Specialty
- Behavior Analyst
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.