Individual
MS. ALYSSA ROSE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1750 COMMERCE CENTER BLVD, FAIRBORN, OH 45324-6333
(937) 878-8444
Mailing address
1750 COMMERCE CENTER BLVD, FAIRBORN, OH 45324-6333
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-48302
OH
Other
Enumeration date
01/28/2018
Last updated
01/28/2018
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