Landon Walker Evans, M.A.
Individual provider Active NPI School Psychologist · Minerva, OH
NPI 1558769976 · NPPES record last updated Dec 17, 2014
Key facts
- NPI
- 1558769976
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- OH3206459 (OH)
- Practice address
- 130 Bonnieview Ave
Minerva, OH 44657-2014 - Phone
- (330) 205-0596
- NPI assigned
- Dec 17, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OH3206459 | OH | MD | School Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | OH3206459 | OH | Yes |
Addresses
Primary practice location
130 Bonnieview Ave
Minerva, OH 44657-2014
Mailing address
130 Bonnieview Ave
Minerva, OH 44657-2014
Phone (330) 205-0596
Other providers in Minerva, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.