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Individual

TANISHA ELZEATHA EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2581 ATLANTIC AVE, BROOKLYN, NY 11207-2412
(718) 495-6700
Mailing address
47 FURMAN AVE APT 6, BROOKLYN, NY 11207-1735
(646) 565-8473

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YA0400X
NY

Other

Enumeration date
04/08/2024
Last updated
04/08/2024
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