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Individual

MISS FARRELL M EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CDS III

Contact information

Practice address
100 EAGLE FEATHER STREET, LAME DEER, MT 59043
(406) 477-4924
(406) 477-6727
Mailing address
PO BOX 135, 836 BRAVEWOLF, BUSBY, MT 59016-0135
(406) 477-4910
(406) 477-8727

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
NWIADSCB09/1711CCP
WA

Other

Enumeration date
11/16/2012
Last updated
11/16/2012
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