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1245706316
ANTONIO EVANS
BASTROP, LA
NPI
1245706316
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-10-16
Last Update Date
2018-12-07
Business Address
ANTONIO EVANS
406 TISDALE DR
BASTROP, LA 71220-3747
Phone number: 189-974-6000
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Mailing Address
ANTONIO EVANS
406 TISDALE DR
BASTROP, LA 71220-3747
Phone number: 189-974-6000
Copy
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