Individual
AILENE EVANGELISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
941 S MCPHERSON CHURCH RD, FAYETTEVILLE, NC 28303-5369
(910) 286-4784
Mailing address
3504 MONUMENT DR APT 102, FAYETTEVILLE, NC 28304-3282
(203) 598-6847
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NC
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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