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Individual

EVARISTO FERNANDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
134 S SAINT CLAIR ST, PAINESVILLE, OH 44077
(440) 205-2686
Mailing address
434 EASTLAND RD, BEREA, OH 44017-1217
(440) 260-8365

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
S1500904
OH
101YM0800X
Mental Health Counselor
Primary
S150094
OH

Other

Enumeration date
01/24/2017
Last updated
05/16/2018
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