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Individual

EVAN RICHARD MIDDAUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2711 N MILDRED AVE APT 2B, CHICAGO, IL 60614-2771
(239) 851-5661
Mailing address
2711 N MILDRED AVE APT 2B, CHICAGO, IL 60614-2771
(239) 851-5661

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.021545
IL

Other

Enumeration date
10/07/2019
Last updated
10/07/2019
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