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Individual

GLENN WILLIAM EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LLPC

Contact information

Practice address
2091 PROFESSIONAL DR, SUITE I-1, FLINT, MI 48532-3657
(810) 732-1652
Mailing address
410 VICTOR DR, SAGINAW, MI 48609-5184
(989) 781-6178

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6401009990
MI

Other

Enumeration date
12/18/2006
Last updated
07/08/2007
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