Individual
CHRISTINE ANN EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 WALNUT ST, ALTO PASS, IL 62905
(612) 516-1904
Mailing address
200 WALNUT ST, ALTO PASS, IL 62905-1018
(612) 516-1904
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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