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Individual

EVAN CARSON BUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
3535 S RICHEY BLVD, TUCSON, AZ 85713-5432
(520) 886-1136
Mailing address
21069 E PROSPECTOR PL, RED ROCK, AZ 85145-5019
(801) 520-5388

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-19564
AZ

Other

Enumeration date
06/30/2021
Last updated
06/30/2021
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