Individual
MS. JUDITH EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
915 BROADWAY, 1309, NEW YORK, NY 10010-7108
(212) 714-7126
Mailing address
474 9TH ST, APT.#1, BROOKLYN, NY 11215-4103
(718) 499-2131
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
000106
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000106
LICENSE
NY
Enumeration date
07/03/2007
Last updated
07/08/2007
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