Individual
TANIA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRADC
Contact information
Practice address
211 N SHAMROCK ST, EAST ALTON, IL 62024-0016
(618) 258-0021
Mailing address
211 N SHAMROCK ST, EAST ALTON, IL 62024-0016
(618) 258-0021
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25625
IL
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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