Individual
ZA-NYA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29 WHITMORE LN, STAMFORD, CT 06902-4524
(203) 309-8548
Mailing address
29 WHITMORE LN, STAMFORD, CT 06902-4524
(203) 309-8548
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-212235
FL
Other
Enumeration date
04/20/2022
Last updated
04/20/2022
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