Individual
EVAN SUMMASUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 BARBERRY LN, CONCORD, NH 03301-2417
(617) 819-0914
Mailing address
PO BOX 4041, CONCORD, NH 03302-4041
(617) 819-0914
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4738
NH
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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