Individual
ETHAN SMITH EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
443 S 600 E, SLC, UT 84102-2708
(801) 536-6523
Mailing address
443 S 600 E, SLC, UT 84102-2708
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/14/2018
Last updated
06/14/2018
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