Individual
EVAN G TACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 N 2ND ST STE 103, NILES, MI 49120-2259
(269) 262-1815
Mailing address
20 N 2ND ST STE 103, NILES, MI 49120-2259
(269) 262-1815
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/24/2022
Last updated
05/24/2022
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