Individual
TIANNA CHRISTINE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 JANUS ST, SPRINGFIELD, OR 97477-3531
(541) 653-5058
Mailing address
1061 JANUS ST, SPRINGFIELD, OR 97477-3531
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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