Individual
CHARLES W EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FOSTER PARENT
Contact information
Practice address
10786 E 39TH ST, YUMA, AZ 85365-7047
(928) 539-5379
Mailing address
10786 E 39TH ST, YUMA, AZ 85365-7047
(928) 539-5379
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
5726
—
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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