Individual
DR. RONALD HOWARD EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
415 SOUTH ST., BRANDEIS UNIVERSITY, PSYCHOLOGICAL COUNSELING, MAILMAN, WALTHAM, MA 02454-9110
(781) 736-3730
(781) 736-3731
Mailing address
PO BOX 54911, 415 SOUTH ST. MS061, BRANDEIS UNIVERSITY, WALTHAM, MA 02454-9110
(781) 736-3730
(781) 736-3731
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
MA4613
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W04449
BLUE CROSS/BLUE SH..
—
Enumeration date
02/11/2009
Last updated
02/11/2009
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