Individual
CONSTANCE EVASIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14042 EDGEWOOD ST, LIVONIA, MI 48154-5334
(734) 620-7785
Mailing address
14042 EDGEWOOD ST, LIVONIA, MI 48154-5334
(734) 620-7785
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201000198
MI
Other
Enumeration date
04/09/2018
Last updated
04/09/2018
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