Organization
EVERGREEN THERAPY SERVICES-LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA M MIDDLETON LSCSW (CLINICAL SOCIAL WORKER)
(785) 483-9183
Entity
Organization
Contact information
Practice address
1819 11TH ST, GREAT BEND, KS 67530-4511
(785) 483-9183
Mailing address
1819 11TH ST, GREAT BEND, KS 67530-4511
(785) 483-9183
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/12/2021
Last updated
08/03/2021
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