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Organization
THERESA A EVANS LMSW PLLC
Active
Organization
THERESA A EVANS LMSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA ANNE EVANS LMSW (CLINICAL SOCIAL WORKER)
(231) 421-5521
Entity
Organization
Contact information
Practice address
3301 VETERANS DR STE 114, TRAVERSE CITY, MI 49684-4564
(231) 421-5521
Mailing address
2506 HOLLAND CIR, TRAVERSE CITY, MI 49685-7410
(231) 943-4386
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972659845
NPPES
—
Enumeration date
07/05/2017
Last updated
07/05/2017
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