Individual
MRS. MARIANE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2064 WOODBURY AVE #204, NEWINGTON, NH 03801-7801
(603) 433-4192
Mailing address
2064 WOODBURY AVE, NEWINGTON, NH 03801-7801
(603) 433-4192
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-13648
NH
Other
Enumeration date
04/27/2015
Last updated
12/20/2016
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