Individual
BRIDGETTE ELAINE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1075 S CHECK ST STE 110, WASILLA, AK 99654-8067
(912) 318-2329
Mailing address
401 N MAIN ST 870630, WASILLA, AK 99687
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
195464
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1735622
—
AK
Enumeration date
07/25/2019
Last updated
04/26/2023
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