Individual
CRAIG F. EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1368 BEACON ST, SUITE 115, BROOKLINE, MA 02446-2872
(617) 734-0184
Mailing address
1368 BEACON ST, SUITE 115, BROOKLINE, MA 02446-2872
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
104927
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P03144
BLUE SHIELD PROVIDER ID
MA
Enumeration date
01/23/2007
Last updated
07/08/2007
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