Individual
IRENA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2794 S ANDERSON LN, GILBERT, AZ 85295-3638
(917) 969-3832
Mailing address
7501 E MCDOWELL RD APT 3026, SCOTTSDALE, AZ 85257-3571
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
N/A
—
Enumeration date
08/24/2018
Last updated
08/24/2018
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